Treatment outcomes of hypofractionated radiotherapy combined with temozolomide followed by bevacizumab salvage therapy in glioblastoma patients aged > 75 years

Int J Clin Oncol. 2018 Oct;23(5):820-825. doi: 10.1007/s10147-018-1298-z. Epub 2018 May 23.

Abstract

Background: The optimal treatment for elderly patients with glioblastoma has not been established.

Methods: We retrospectively analyzed the safety and efficacy of hypofractionated radiotherapy (45 Gy/15 fr) combined with temozolomide (TMZ) followed by bevacizumab (BEV) salvage treatment in 18 glioblastoma patients aged > 75 years.

Results: All of the patients received safe hypofractionated radiotherapy and concomitant TMZ (75 mg/m2), and 14 of 18 patients received maintenance TMZ. We administered BEV to 17 of 18 patients because their Karnofsky Performance Status scores declined and/or recurrence was detected. During the follow-up period (median duration: 17.5 months, range 3-33 months), 12 patients died of their disease. While the median progression-free survival period was 2.5 months, the median overall survival period was 20 months. Adverse events (National Cancer Institute Common Terminology Criteria for Adverse Events grade 3 or 4) occurred in 5 patients.

Conclusion: Hypofractionated radiotherapy combined with TMZ and BEV salvage treatment was found to be safe and effective in glioblastoma patients aged > 75 years.

Keywords: Bevacizumab; Elderly; Glioblastoma; Hypofractionated radiotherapy; Temozolomide.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Bevacizumab / administration & dosage
  • Brain Neoplasms / pathology
  • Brain Neoplasms / therapy*
  • Chemoradiotherapy / mortality*
  • Dacarbazine / administration & dosage
  • Dacarbazine / analogs & derivatives
  • Dose Fractionation, Radiation
  • Female
  • Glioblastoma / pathology
  • Glioblastoma / therapy*
  • Humans
  • Male
  • Retrospective Studies
  • Salvage Therapy*
  • Survival Rate
  • Temozolomide
  • Treatment Outcome

Substances

  • Bevacizumab
  • Dacarbazine
  • Temozolomide