P17.92 GLIOBLASTOMA IN ELDERLY PATIENTS: SURVIVAL OUTCOME

BACKGROUND: The management of glioblastoma (GB) in elderly patients is not well established. The incidence is higher in this population and is expected to increase over the next decades in relation with an aging population in western countries. Otherwise GB is the most life-threatening primary brain tumor especially in elderly patients and survival is significantly less than seen in younger patients. Until recently, this patients have been excluded from randomized trials and the effectiveness of the conventional active treatment has been controversial, since benefit was attenuated in older and there are concerns about mental deterioration. Different treatment approaches have been proposed. Here we review our experience in this population. METHODS: The authors retrospectively reviewed 53 patients at a single institution from February 2005 to March 2013. Patients were 70 years of age and older with histologically confirmed GB. RESULTS: Median age was 75 years (range 70-88). Fifty-six percent were men and 43% women. Most had frontal lobe location (37.7%) followed by temporal lobe (32%). Majority of patients had some kind of morbidity (89%), mainly arterial hypertension (55%) diabetes (13%) and thyroid function alteration (17%). Partial resection was planned in 49% of cases and a complete resection in 45%. After surgery, 71% received radiotherapy, in 45% of cases the dose was 60 Gy and in 26% was 30 Gy. Nearly 40% were treated with concomitant and adjuvant temozolomide. The median umber of cycles was 4,43 (range 1-14). Median survival for the whole cohort was 7,36 m (95% CI 4,8-9,8) and 8,3m for those who received some kind of treatment after surgery. Treatment with temozolomide concomitant and adjuvant (Stupp regimen) was associated with longer overall survival ( 11,16 months vs 4,1m p = 0.008 ). The median overall survival was 8,3 months for those who received radiotherapy and 1,5m for those who did not (p = 0,046). Differences were found between those treated with 30 or 60 Gy in terms of overall survival in favor of 60Gy treatment ( 6,3 vs 11,1 m) but didnt reach the statistical significance level (p = 0.143). Compared with temporal location, patients with tumor located in parietal lobe had a better overall survival. In 10% of cases received a second line treatment after progression and median survival was 4,8 months. CONCLUSION: Elderly patients diagnosed with GB had worst prognosis. In our experience, in patients with newly diagnosed glioblastoma over the