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Oncological patterns of care and outcomes for 265 elderly patients with newly diagnosed glioblastoma in France |
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| Authors: | Sonia Zouaoui Amélie Darlix Pascale Fabbro-Peray Hélène Mathieu-Daudé Valérie Rigau Michel Fabbro Faiza Bessaoud Luc Taillandier François Ducray Fabienne Bauchet Michel Wager Thierry Faillot Laurent Capelle Hugues Loiseau Christine Kerr Philippe Menei Hugues Duffau Dominique Figarella-Branger Olivier Chinot Brigitte Trétarre Luc Bauchet |
| Affiliation: | 1. Department of Neurosurgery and INSERM U1051, H?pital Saint Eloi—Gui de Chauliac, Centre Hospitalier Universitaire, 80 avenue Augustin Fliche, 34 295, Montpellier cedex 5, France 2. Department of Medical Oncology and Department of Radiation Oncology, ICM, Montpellier, France 3. Department of Biostatistics, Institut Universitaire de Recherche Clinique, Montpellier, France and BESPIM, Centre Hospitalier Universitaire, N?mes, France 4. Department of Epidemiology, Groupe de Neuro-Oncologie du Languedoc-Roussillon, Registre des Tumeurs de l’Hérault, ICM, Montpellier, France 5. Department of Pathology, Centre Hospitalier Universitaire, H?pital Gui de Chauliac, Montpellier, France 6. Department of Medical Oncology and Department of Radiation Oncology, Centre de Lutte Contre le Cancer Val d’Aurelle, Montpellier, France 7. Neuro Oncology Unit, Department of Neurology, Centre Hospitalier Universitaire, Poitiers, France 8. Department of Neuro-Oncology, H?pital Neurologique, Lyon, France 9. Department of Neurosurgery, Centre Hospitalier Universitaire La Milétrie, Poitiers, France 10. Department of Neurosurgery, AP-HP H?pital Beaujon, Clichy, France 11. Department of Neurosurgery, AP-HP H?pital Pitié-Salpêtrière, Paris, France 12. Department of Neurosurgery, Centre Hospitalier Universitaire Pellegrin, Bordeaux, France 13. Department of Neurosurgery, Centre Hospitalier Universitaire, Angers, France 14. Department of Neuropathology and Inserm U 911, H?pital de la Timone, Université de la Méditerranée, Marseille, France 15. Department of Neuro-Oncology, H?pital de la Timone, Université de la Méditerranée, Marseille, France |
| Abstract: | The incidence of glioblastoma (GBM) has increased in patients aged 70 years or older, and will continue to grow. Elderly GBM patients have been excluded from most clinical trials; furthermore, optimal care management as well as benefit/risk ratio of GBM treatments are still being debated. This study describes oncological patterns of care, prognostic factors, and survival for patients ≥70 years in France. We identified patients over 70 with newly diagnosed and histologically confirmed GBM on data previously published by the French Brain Tumor DataBase. We included 265 patients. Neurological deficits and mental status disorders were the most frequent symptoms. The surgery consisted of resection (RS n?=?95) or biopsy (B n?=?170); 98 patients did not have subsequent oncological treatment. After surgery, first-line treatment consisted of radiotherapy (RT n?=?76), chemotherapy (CT n?=?52), and concomitant radiochemotherapy (CRC n?=?39). The median age at diagnosis was 76, 74, and 73 years, respectively, for the untreated, B?+?RT and/or CT, RS?±?RT and/or CT groups. Median survival (in days, 95 % CI) with these main strategies, when analyzed according to surgical groups, was: B-CT n?=?41, 199[155–280]; B-CRC n?=?21, 318[166–480]; B-RT n?=?37, 149[130–214]; RS-CT n?=?11, 245[211–na]; RS-CRC n?=?18, 372[349–593]; RS-RT n?=?39, 269[218–343]. This population study for elderly GBM patients is one of the most important in Europe, and could be considered as a historical cohort to compare future treatments. Moreover, we can hypothesize that elderly patients (versus patients <70 years) are undertreated. Karnofsky performance status seems to be the most relevant clinical predictive factor, and RS and CRC have a positive impact on survival for elderly GBM patients in the general population, at least when feasible. |
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