P08.13 Pattern of care and outcome in elderly glioblastoma patients: a multicenter retrospective study on 151 patientsi from 3 hospitals in Lombardia

Pending the results of the 26062 EORTC trial, no standard of care exists for elderly patients with glioblastoma. Randomized controlled trials have provided evidence of a slight survival benefit for radiotherapy versus best supportive care (Keime-Guibert) and of lack of substantial benefit from single post-surgical treatment over each other. Treatment is still largely variable according to local practice. In this study we investigated the pattern of care and outcome in patients older than 65 diagnosed with glioblatoma in 3 hospitals in Lombardia and analyzed factors with impact on survival. 151 patients were included in this study, enrolled in Lecco Hospital, Niguarda Hospital and Neurooncology Unit of Fondazione IRCCS Istituto Neurologico Besta and undergoing surgery from 2004 to 2014. 91 were male, 60 female. Age range was 65 to 83, with a median value of 72. Concerning clinical variables, KPS was 70 or higher in 109 patients and lower in 42. 19 patients underwent biopsy, 14 partial resection and 118 total/subtotal resection as evaluated by the neurosurgeon. 114 patients were treated with radiotherapy and 97 with chemotherapy (all these 97 also received radiotherapy). 32 patients displayed seizures at disease onset. 22 patients did not receive antiepileptic treatment, while 129 were treated with antiepileptic drugs despite absence of seizures in 48. 40% of patients treated with antiepileptic drugs received enzyme-inducing drugs, 60% were treated with either VPA or levetiracetam. At disease progression, 22 patients received further treatment, including repeat surgery and/or second-line chemotherapy. In only 36 patients were molecular biology tests performed (IDH1 mutation). At univariate analysis, survival was longer in patients with higher KPS (p=0.02), those receiving partial/total surgery vs biopsy (p=0.03), those receiving total resection (p=0.003), those treated with radiotherapy (p