Treatment strategies for glioblastoma in older patients: age is just a number
Background/purpose Optimal care for elderly patients with glioblastoma (GBM) remains in question due to their exclusion from and underrepresentation in many clinical trials (including EORTC 22,981) as well as their historically poor overall survival. Methods A retrospective chart review was conducte...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Youssef, Michael [verfasserIn] Ludmir, Ethan B. [verfasserIn] Mandel, Jacob J. [verfasserIn] Patel, Akash J. [verfasserIn] Jalali, Ali [verfasserIn] Treiber, Jeffrey [verfasserIn] Wu, Jimin [verfasserIn] McAleer, Mary Frances [verfasserIn] de Groot, John F. [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2019 |
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| Schlagwörter: |
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| Übergeordnetes Werk: |
Enthalten in: Journal of neuro-oncology - Dordrecht [u.a.] : Springer Science + Business Media B.V, 1983, 145(2019), 2 vom: 23. Okt., Seite 357-364 |
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| Übergeordnetes Werk: |
volume:145 ; year:2019 ; number:2 ; day:23 ; month:10 ; pages:357-364 |
| Links: |
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| DOI / URN: |
10.1007/s11060-019-03304-x |
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| Katalog-ID: |
SPR016197283 |
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| 100 | 1 | |a Youssef, Michael |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Treatment strategies for glioblastoma in older patients: age is just a number |
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| 520 | |a Background/purpose Optimal care for elderly patients with glioblastoma (GBM) remains in question due to their exclusion from and underrepresentation in many clinical trials (including EORTC 22,981) as well as their historically poor overall survival. Methods A retrospective chart review was conducted at a single high-volume cancer center for newly diagnosed elderly (65 years old or older) GBM patients diagnosed from 2011 through 2017. Results A total of 158 newly diagnosed GBM patients aged 65 years and older were identified. One hundred forty-four patients (91.1%) received radiotherapy (RT) and 130 patients (90.3%) received concurrent temozolomide with RT. Sixty-one patients (38.6%) completed concurrent chemoradiation and 6 cycles of adjuvant temozolomide. 23% of patients discontinued temozolomide during concurrent or adjuvant treatment due to side effects or complications of chemotherapy. With a median follow-up time of 35.0 months, median overall survival (OS) time for the full cohort was 18.6 months, with estimated OS rates of 74.8%, 35.9%, and 9.5% at 1, 2, and 5 years, respectively. On multivariable analysis, higher KPS (p = 0.002, HR 0.46; 95% CI 0.63–0.82), completing planned RT course (p = 0.01, HR 0.29; 95% CI 0.11–0.75), and completing 6 cycles of adjuvant temozolomide (p = 0.01, HR 2.62; 95% CI 1.67–4.12) were independently associated with improved OS. Conclusions Our cohort of elderly GBM patients was predominantly treated with standard of care therapy based on EORTC 22,981. Despite their age, these patients generally tolerated treatment well and had favorable outcomes compared to those reported for patients treated on EORTC 22,981. Based on these findings, using advanced age as the basis for treatment de-escalation or as an exclusionary criterion in clinical trials should be discouraged. | ||
| 650 | 4 | |a Elderly |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Glioblastoma |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Hypofractionated |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a MGMT |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Overall survival |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Radiotherapy |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Temozolomide |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Adjuvant |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Concurrent |7 (dpeaa)DE-He213 | |
| 700 | 1 | |a Ludmir, Ethan B. |e verfasserin |4 aut | |
| 700 | 1 | |a Mandel, Jacob J. |e verfasserin |4 aut | |
| 700 | 1 | |a Patel, Akash J. |e verfasserin |4 aut | |
| 700 | 1 | |a Jalali, Ali |e verfasserin |4 aut | |
| 700 | 1 | |a Treiber, Jeffrey |e verfasserin |4 aut | |
| 700 | 1 | |a Wu, Jimin |e verfasserin |4 aut | |
| 700 | 1 | |a McAleer, Mary Frances |e verfasserin |4 aut | |
| 700 | 1 | |a de Groot, John F. |e verfasserin |4 aut | |
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10.1007/s11060-019-03304-x doi (DE-627)SPR016197283 (SPR)s11060-019-03304-x-e DE-627 ger DE-627 rakwb eng 610 ASE 44.81 bkl 44.90 bkl Youssef, Michael verfasserin aut Treatment strategies for glioblastoma in older patients: age is just a number 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background/purpose Optimal care for elderly patients with glioblastoma (GBM) remains in question due to their exclusion from and underrepresentation in many clinical trials (including EORTC 22,981) as well as their historically poor overall survival. Methods A retrospective chart review was conducted at a single high-volume cancer center for newly diagnosed elderly (65 years old or older) GBM patients diagnosed from 2011 through 2017. Results A total of 158 newly diagnosed GBM patients aged 65 years and older were identified. One hundred forty-four patients (91.1%) received radiotherapy (RT) and 130 patients (90.3%) received concurrent temozolomide with RT. Sixty-one patients (38.6%) completed concurrent chemoradiation and 6 cycles of adjuvant temozolomide. 23% of patients discontinued temozolomide during concurrent or adjuvant treatment due to side effects or complications of chemotherapy. With a median follow-up time of 35.0 months, median overall survival (OS) time for the full cohort was 18.6 months, with estimated OS rates of 74.8%, 35.9%, and 9.5% at 1, 2, and 5 years, respectively. On multivariable analysis, higher KPS (p = 0.002, HR 0.46; 95% CI 0.63–0.82), completing planned RT course (p = 0.01, HR 0.29; 95% CI 0.11–0.75), and completing 6 cycles of adjuvant temozolomide (p = 0.01, HR 2.62; 95% CI 1.67–4.12) were independently associated with improved OS. Conclusions Our cohort of elderly GBM patients was predominantly treated with standard of care therapy based on EORTC 22,981. Despite their age, these patients generally tolerated treatment well and had favorable outcomes compared to those reported for patients treated on EORTC 22,981. Based on these findings, using advanced age as the basis for treatment de-escalation or as an exclusionary criterion in clinical trials should be discouraged. Elderly (dpeaa)DE-He213 Glioblastoma (dpeaa)DE-He213 Hypofractionated (dpeaa)DE-He213 MGMT (dpeaa)DE-He213 Overall survival (dpeaa)DE-He213 Radiotherapy (dpeaa)DE-He213 Temozolomide (dpeaa)DE-He213 Adjuvant (dpeaa)DE-He213 Concurrent (dpeaa)DE-He213 Ludmir, Ethan B. verfasserin aut Mandel, Jacob J. verfasserin aut Patel, Akash J. verfasserin aut Jalali, Ali verfasserin aut Treiber, Jeffrey verfasserin aut Wu, Jimin verfasserin aut McAleer, Mary Frances verfasserin aut de Groot, John F. verfasserin aut Enthalten in Journal of neuro-oncology Dordrecht [u.a.] : Springer Science + Business Media B.V, 1983 145(2019), 2 vom: 23. Okt., Seite 357-364 (DE-627)32046122X (DE-600)2007293-4 1573-7373 nnns volume:145 year:2019 number:2 day:23 month:10 pages:357-364 https://dx.doi.org/10.1007/s11060-019-03304-x lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.81 ASE 44.90 ASE AR 145 2019 2 23 10 357-364 |
| spelling |
10.1007/s11060-019-03304-x doi (DE-627)SPR016197283 (SPR)s11060-019-03304-x-e DE-627 ger DE-627 rakwb eng 610 ASE 44.81 bkl 44.90 bkl Youssef, Michael verfasserin aut Treatment strategies for glioblastoma in older patients: age is just a number 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background/purpose Optimal care for elderly patients with glioblastoma (GBM) remains in question due to their exclusion from and underrepresentation in many clinical trials (including EORTC 22,981) as well as their historically poor overall survival. Methods A retrospective chart review was conducted at a single high-volume cancer center for newly diagnosed elderly (65 years old or older) GBM patients diagnosed from 2011 through 2017. Results A total of 158 newly diagnosed GBM patients aged 65 years and older were identified. One hundred forty-four patients (91.1%) received radiotherapy (RT) and 130 patients (90.3%) received concurrent temozolomide with RT. Sixty-one patients (38.6%) completed concurrent chemoradiation and 6 cycles of adjuvant temozolomide. 23% of patients discontinued temozolomide during concurrent or adjuvant treatment due to side effects or complications of chemotherapy. With a median follow-up time of 35.0 months, median overall survival (OS) time for the full cohort was 18.6 months, with estimated OS rates of 74.8%, 35.9%, and 9.5% at 1, 2, and 5 years, respectively. On multivariable analysis, higher KPS (p = 0.002, HR 0.46; 95% CI 0.63–0.82), completing planned RT course (p = 0.01, HR 0.29; 95% CI 0.11–0.75), and completing 6 cycles of adjuvant temozolomide (p = 0.01, HR 2.62; 95% CI 1.67–4.12) were independently associated with improved OS. Conclusions Our cohort of elderly GBM patients was predominantly treated with standard of care therapy based on EORTC 22,981. Despite their age, these patients generally tolerated treatment well and had favorable outcomes compared to those reported for patients treated on EORTC 22,981. Based on these findings, using advanced age as the basis for treatment de-escalation or as an exclusionary criterion in clinical trials should be discouraged. Elderly (dpeaa)DE-He213 Glioblastoma (dpeaa)DE-He213 Hypofractionated (dpeaa)DE-He213 MGMT (dpeaa)DE-He213 Overall survival (dpeaa)DE-He213 Radiotherapy (dpeaa)DE-He213 Temozolomide (dpeaa)DE-He213 Adjuvant (dpeaa)DE-He213 Concurrent (dpeaa)DE-He213 Ludmir, Ethan B. verfasserin aut Mandel, Jacob J. verfasserin aut Patel, Akash J. verfasserin aut Jalali, Ali verfasserin aut Treiber, Jeffrey verfasserin aut Wu, Jimin verfasserin aut McAleer, Mary Frances verfasserin aut de Groot, John F. verfasserin aut Enthalten in Journal of neuro-oncology Dordrecht [u.a.] : Springer Science + Business Media B.V, 1983 145(2019), 2 vom: 23. Okt., Seite 357-364 (DE-627)32046122X (DE-600)2007293-4 1573-7373 nnns volume:145 year:2019 number:2 day:23 month:10 pages:357-364 https://dx.doi.org/10.1007/s11060-019-03304-x lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.81 ASE 44.90 ASE AR 145 2019 2 23 10 357-364 |
| allfields_unstemmed |
10.1007/s11060-019-03304-x doi (DE-627)SPR016197283 (SPR)s11060-019-03304-x-e DE-627 ger DE-627 rakwb eng 610 ASE 44.81 bkl 44.90 bkl Youssef, Michael verfasserin aut Treatment strategies for glioblastoma in older patients: age is just a number 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background/purpose Optimal care for elderly patients with glioblastoma (GBM) remains in question due to their exclusion from and underrepresentation in many clinical trials (including EORTC 22,981) as well as their historically poor overall survival. Methods A retrospective chart review was conducted at a single high-volume cancer center for newly diagnosed elderly (65 years old or older) GBM patients diagnosed from 2011 through 2017. Results A total of 158 newly diagnosed GBM patients aged 65 years and older were identified. One hundred forty-four patients (91.1%) received radiotherapy (RT) and 130 patients (90.3%) received concurrent temozolomide with RT. Sixty-one patients (38.6%) completed concurrent chemoradiation and 6 cycles of adjuvant temozolomide. 23% of patients discontinued temozolomide during concurrent or adjuvant treatment due to side effects or complications of chemotherapy. With a median follow-up time of 35.0 months, median overall survival (OS) time for the full cohort was 18.6 months, with estimated OS rates of 74.8%, 35.9%, and 9.5% at 1, 2, and 5 years, respectively. On multivariable analysis, higher KPS (p = 0.002, HR 0.46; 95% CI 0.63–0.82), completing planned RT course (p = 0.01, HR 0.29; 95% CI 0.11–0.75), and completing 6 cycles of adjuvant temozolomide (p = 0.01, HR 2.62; 95% CI 1.67–4.12) were independently associated with improved OS. Conclusions Our cohort of elderly GBM patients was predominantly treated with standard of care therapy based on EORTC 22,981. Despite their age, these patients generally tolerated treatment well and had favorable outcomes compared to those reported for patients treated on EORTC 22,981. Based on these findings, using advanced age as the basis for treatment de-escalation or as an exclusionary criterion in clinical trials should be discouraged. Elderly (dpeaa)DE-He213 Glioblastoma (dpeaa)DE-He213 Hypofractionated (dpeaa)DE-He213 MGMT (dpeaa)DE-He213 Overall survival (dpeaa)DE-He213 Radiotherapy (dpeaa)DE-He213 Temozolomide (dpeaa)DE-He213 Adjuvant (dpeaa)DE-He213 Concurrent (dpeaa)DE-He213 Ludmir, Ethan B. verfasserin aut Mandel, Jacob J. verfasserin aut Patel, Akash J. verfasserin aut Jalali, Ali verfasserin aut Treiber, Jeffrey verfasserin aut Wu, Jimin verfasserin aut McAleer, Mary Frances verfasserin aut de Groot, John F. verfasserin aut Enthalten in Journal of neuro-oncology Dordrecht [u.a.] : Springer Science + Business Media B.V, 1983 145(2019), 2 vom: 23. Okt., Seite 357-364 (DE-627)32046122X (DE-600)2007293-4 1573-7373 nnns volume:145 year:2019 number:2 day:23 month:10 pages:357-364 https://dx.doi.org/10.1007/s11060-019-03304-x lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.81 ASE 44.90 ASE AR 145 2019 2 23 10 357-364 |
| allfieldsGer |
10.1007/s11060-019-03304-x doi (DE-627)SPR016197283 (SPR)s11060-019-03304-x-e DE-627 ger DE-627 rakwb eng 610 ASE 44.81 bkl 44.90 bkl Youssef, Michael verfasserin aut Treatment strategies for glioblastoma in older patients: age is just a number 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background/purpose Optimal care for elderly patients with glioblastoma (GBM) remains in question due to their exclusion from and underrepresentation in many clinical trials (including EORTC 22,981) as well as their historically poor overall survival. Methods A retrospective chart review was conducted at a single high-volume cancer center for newly diagnosed elderly (65 years old or older) GBM patients diagnosed from 2011 through 2017. Results A total of 158 newly diagnosed GBM patients aged 65 years and older were identified. One hundred forty-four patients (91.1%) received radiotherapy (RT) and 130 patients (90.3%) received concurrent temozolomide with RT. Sixty-one patients (38.6%) completed concurrent chemoradiation and 6 cycles of adjuvant temozolomide. 23% of patients discontinued temozolomide during concurrent or adjuvant treatment due to side effects or complications of chemotherapy. With a median follow-up time of 35.0 months, median overall survival (OS) time for the full cohort was 18.6 months, with estimated OS rates of 74.8%, 35.9%, and 9.5% at 1, 2, and 5 years, respectively. On multivariable analysis, higher KPS (p = 0.002, HR 0.46; 95% CI 0.63–0.82), completing planned RT course (p = 0.01, HR 0.29; 95% CI 0.11–0.75), and completing 6 cycles of adjuvant temozolomide (p = 0.01, HR 2.62; 95% CI 1.67–4.12) were independently associated with improved OS. Conclusions Our cohort of elderly GBM patients was predominantly treated with standard of care therapy based on EORTC 22,981. Despite their age, these patients generally tolerated treatment well and had favorable outcomes compared to those reported for patients treated on EORTC 22,981. Based on these findings, using advanced age as the basis for treatment de-escalation or as an exclusionary criterion in clinical trials should be discouraged. Elderly (dpeaa)DE-He213 Glioblastoma (dpeaa)DE-He213 Hypofractionated (dpeaa)DE-He213 MGMT (dpeaa)DE-He213 Overall survival (dpeaa)DE-He213 Radiotherapy (dpeaa)DE-He213 Temozolomide (dpeaa)DE-He213 Adjuvant (dpeaa)DE-He213 Concurrent (dpeaa)DE-He213 Ludmir, Ethan B. verfasserin aut Mandel, Jacob J. verfasserin aut Patel, Akash J. verfasserin aut Jalali, Ali verfasserin aut Treiber, Jeffrey verfasserin aut Wu, Jimin verfasserin aut McAleer, Mary Frances verfasserin aut de Groot, John F. verfasserin aut Enthalten in Journal of neuro-oncology Dordrecht [u.a.] : Springer Science + Business Media B.V, 1983 145(2019), 2 vom: 23. Okt., Seite 357-364 (DE-627)32046122X (DE-600)2007293-4 1573-7373 nnns volume:145 year:2019 number:2 day:23 month:10 pages:357-364 https://dx.doi.org/10.1007/s11060-019-03304-x lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.81 ASE 44.90 ASE AR 145 2019 2 23 10 357-364 |
| allfieldsSound |
10.1007/s11060-019-03304-x doi (DE-627)SPR016197283 (SPR)s11060-019-03304-x-e DE-627 ger DE-627 rakwb eng 610 ASE 44.81 bkl 44.90 bkl Youssef, Michael verfasserin aut Treatment strategies for glioblastoma in older patients: age is just a number 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background/purpose Optimal care for elderly patients with glioblastoma (GBM) remains in question due to their exclusion from and underrepresentation in many clinical trials (including EORTC 22,981) as well as their historically poor overall survival. Methods A retrospective chart review was conducted at a single high-volume cancer center for newly diagnosed elderly (65 years old or older) GBM patients diagnosed from 2011 through 2017. Results A total of 158 newly diagnosed GBM patients aged 65 years and older were identified. One hundred forty-four patients (91.1%) received radiotherapy (RT) and 130 patients (90.3%) received concurrent temozolomide with RT. Sixty-one patients (38.6%) completed concurrent chemoradiation and 6 cycles of adjuvant temozolomide. 23% of patients discontinued temozolomide during concurrent or adjuvant treatment due to side effects or complications of chemotherapy. With a median follow-up time of 35.0 months, median overall survival (OS) time for the full cohort was 18.6 months, with estimated OS rates of 74.8%, 35.9%, and 9.5% at 1, 2, and 5 years, respectively. On multivariable analysis, higher KPS (p = 0.002, HR 0.46; 95% CI 0.63–0.82), completing planned RT course (p = 0.01, HR 0.29; 95% CI 0.11–0.75), and completing 6 cycles of adjuvant temozolomide (p = 0.01, HR 2.62; 95% CI 1.67–4.12) were independently associated with improved OS. Conclusions Our cohort of elderly GBM patients was predominantly treated with standard of care therapy based on EORTC 22,981. Despite their age, these patients generally tolerated treatment well and had favorable outcomes compared to those reported for patients treated on EORTC 22,981. Based on these findings, using advanced age as the basis for treatment de-escalation or as an exclusionary criterion in clinical trials should be discouraged. Elderly (dpeaa)DE-He213 Glioblastoma (dpeaa)DE-He213 Hypofractionated (dpeaa)DE-He213 MGMT (dpeaa)DE-He213 Overall survival (dpeaa)DE-He213 Radiotherapy (dpeaa)DE-He213 Temozolomide (dpeaa)DE-He213 Adjuvant (dpeaa)DE-He213 Concurrent (dpeaa)DE-He213 Ludmir, Ethan B. verfasserin aut Mandel, Jacob J. verfasserin aut Patel, Akash J. verfasserin aut Jalali, Ali verfasserin aut Treiber, Jeffrey verfasserin aut Wu, Jimin verfasserin aut McAleer, Mary Frances verfasserin aut de Groot, John F. verfasserin aut Enthalten in Journal of neuro-oncology Dordrecht [u.a.] : Springer Science + Business Media B.V, 1983 145(2019), 2 vom: 23. Okt., Seite 357-364 (DE-627)32046122X (DE-600)2007293-4 1573-7373 nnns volume:145 year:2019 number:2 day:23 month:10 pages:357-364 https://dx.doi.org/10.1007/s11060-019-03304-x lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.81 ASE 44.90 ASE AR 145 2019 2 23 10 357-364 |
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Elderly Glioblastoma Hypofractionated MGMT Overall survival Radiotherapy Temozolomide Adjuvant Concurrent |
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Youssef, Michael @@aut@@ Ludmir, Ethan B. @@aut@@ Mandel, Jacob J. @@aut@@ Patel, Akash J. @@aut@@ Jalali, Ali @@aut@@ Treiber, Jeffrey @@aut@@ Wu, Jimin @@aut@@ McAleer, Mary Frances @@aut@@ de Groot, John F. @@aut@@ |
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|
| author |
Youssef, Michael |
| spellingShingle |
Youssef, Michael ddc 610 bkl 44.81 bkl 44.90 misc Elderly misc Glioblastoma misc Hypofractionated misc MGMT misc Overall survival misc Radiotherapy misc Temozolomide misc Adjuvant misc Concurrent Treatment strategies for glioblastoma in older patients: age is just a number |
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1573-7373 |
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610 ASE 44.81 bkl 44.90 bkl Treatment strategies for glioblastoma in older patients: age is just a number Elderly (dpeaa)DE-He213 Glioblastoma (dpeaa)DE-He213 Hypofractionated (dpeaa)DE-He213 MGMT (dpeaa)DE-He213 Overall survival (dpeaa)DE-He213 Radiotherapy (dpeaa)DE-He213 Temozolomide (dpeaa)DE-He213 Adjuvant (dpeaa)DE-He213 Concurrent (dpeaa)DE-He213 |
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ddc 610 bkl 44.81 bkl 44.90 misc Elderly misc Glioblastoma misc Hypofractionated misc MGMT misc Overall survival misc Radiotherapy misc Temozolomide misc Adjuvant misc Concurrent |
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ddc 610 bkl 44.81 bkl 44.90 misc Elderly misc Glioblastoma misc Hypofractionated misc MGMT misc Overall survival misc Radiotherapy misc Temozolomide misc Adjuvant misc Concurrent |
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ddc 610 bkl 44.81 bkl 44.90 misc Elderly misc Glioblastoma misc Hypofractionated misc MGMT misc Overall survival misc Radiotherapy misc Temozolomide misc Adjuvant misc Concurrent |
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Journal of neuro-oncology |
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Journal of neuro-oncology |
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Treatment strategies for glioblastoma in older patients: age is just a number |
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Treatment strategies for glioblastoma in older patients: age is just a number |
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Youssef, Michael |
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Journal of neuro-oncology |
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Journal of neuro-oncology |
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eng |
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2019 |
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357 |
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Youssef, Michael Ludmir, Ethan B. Mandel, Jacob J. Patel, Akash J. Jalali, Ali Treiber, Jeffrey Wu, Jimin McAleer, Mary Frances de Groot, John F. |
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10.1007/s11060-019-03304-x |
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610 |
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treatment strategies for glioblastoma in older patients: age is just a number |
| title_auth |
Treatment strategies for glioblastoma in older patients: age is just a number |
| abstract |
Background/purpose Optimal care for elderly patients with glioblastoma (GBM) remains in question due to their exclusion from and underrepresentation in many clinical trials (including EORTC 22,981) as well as their historically poor overall survival. Methods A retrospective chart review was conducted at a single high-volume cancer center for newly diagnosed elderly (65 years old or older) GBM patients diagnosed from 2011 through 2017. Results A total of 158 newly diagnosed GBM patients aged 65 years and older were identified. One hundred forty-four patients (91.1%) received radiotherapy (RT) and 130 patients (90.3%) received concurrent temozolomide with RT. Sixty-one patients (38.6%) completed concurrent chemoradiation and 6 cycles of adjuvant temozolomide. 23% of patients discontinued temozolomide during concurrent or adjuvant treatment due to side effects or complications of chemotherapy. With a median follow-up time of 35.0 months, median overall survival (OS) time for the full cohort was 18.6 months, with estimated OS rates of 74.8%, 35.9%, and 9.5% at 1, 2, and 5 years, respectively. On multivariable analysis, higher KPS (p = 0.002, HR 0.46; 95% CI 0.63–0.82), completing planned RT course (p = 0.01, HR 0.29; 95% CI 0.11–0.75), and completing 6 cycles of adjuvant temozolomide (p = 0.01, HR 2.62; 95% CI 1.67–4.12) were independently associated with improved OS. Conclusions Our cohort of elderly GBM patients was predominantly treated with standard of care therapy based on EORTC 22,981. Despite their age, these patients generally tolerated treatment well and had favorable outcomes compared to those reported for patients treated on EORTC 22,981. Based on these findings, using advanced age as the basis for treatment de-escalation or as an exclusionary criterion in clinical trials should be discouraged. |
| abstractGer |
Background/purpose Optimal care for elderly patients with glioblastoma (GBM) remains in question due to their exclusion from and underrepresentation in many clinical trials (including EORTC 22,981) as well as their historically poor overall survival. Methods A retrospective chart review was conducted at a single high-volume cancer center for newly diagnosed elderly (65 years old or older) GBM patients diagnosed from 2011 through 2017. Results A total of 158 newly diagnosed GBM patients aged 65 years and older were identified. One hundred forty-four patients (91.1%) received radiotherapy (RT) and 130 patients (90.3%) received concurrent temozolomide with RT. Sixty-one patients (38.6%) completed concurrent chemoradiation and 6 cycles of adjuvant temozolomide. 23% of patients discontinued temozolomide during concurrent or adjuvant treatment due to side effects or complications of chemotherapy. With a median follow-up time of 35.0 months, median overall survival (OS) time for the full cohort was 18.6 months, with estimated OS rates of 74.8%, 35.9%, and 9.5% at 1, 2, and 5 years, respectively. On multivariable analysis, higher KPS (p = 0.002, HR 0.46; 95% CI 0.63–0.82), completing planned RT course (p = 0.01, HR 0.29; 95% CI 0.11–0.75), and completing 6 cycles of adjuvant temozolomide (p = 0.01, HR 2.62; 95% CI 1.67–4.12) were independently associated with improved OS. Conclusions Our cohort of elderly GBM patients was predominantly treated with standard of care therapy based on EORTC 22,981. Despite their age, these patients generally tolerated treatment well and had favorable outcomes compared to those reported for patients treated on EORTC 22,981. Based on these findings, using advanced age as the basis for treatment de-escalation or as an exclusionary criterion in clinical trials should be discouraged. |
| abstract_unstemmed |
Background/purpose Optimal care for elderly patients with glioblastoma (GBM) remains in question due to their exclusion from and underrepresentation in many clinical trials (including EORTC 22,981) as well as their historically poor overall survival. Methods A retrospective chart review was conducted at a single high-volume cancer center for newly diagnosed elderly (65 years old or older) GBM patients diagnosed from 2011 through 2017. Results A total of 158 newly diagnosed GBM patients aged 65 years and older were identified. One hundred forty-four patients (91.1%) received radiotherapy (RT) and 130 patients (90.3%) received concurrent temozolomide with RT. Sixty-one patients (38.6%) completed concurrent chemoradiation and 6 cycles of adjuvant temozolomide. 23% of patients discontinued temozolomide during concurrent or adjuvant treatment due to side effects or complications of chemotherapy. With a median follow-up time of 35.0 months, median overall survival (OS) time for the full cohort was 18.6 months, with estimated OS rates of 74.8%, 35.9%, and 9.5% at 1, 2, and 5 years, respectively. On multivariable analysis, higher KPS (p = 0.002, HR 0.46; 95% CI 0.63–0.82), completing planned RT course (p = 0.01, HR 0.29; 95% CI 0.11–0.75), and completing 6 cycles of adjuvant temozolomide (p = 0.01, HR 2.62; 95% CI 1.67–4.12) were independently associated with improved OS. Conclusions Our cohort of elderly GBM patients was predominantly treated with standard of care therapy based on EORTC 22,981. Despite their age, these patients generally tolerated treatment well and had favorable outcomes compared to those reported for patients treated on EORTC 22,981. Based on these findings, using advanced age as the basis for treatment de-escalation or as an exclusionary criterion in clinical trials should be discouraged. |
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Treatment strategies for glioblastoma in older patients: age is just a number |
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https://dx.doi.org/10.1007/s11060-019-03304-x |
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Ludmir, Ethan B. Mandel, Jacob J. Patel, Akash J. Jalali, Ali Treiber, Jeffrey Wu, Jimin McAleer, Mary Frances de Groot, John F. |
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Ludmir, Ethan B. Mandel, Jacob J. Patel, Akash J. Jalali, Ali Treiber, Jeffrey Wu, Jimin McAleer, Mary Frances de Groot, John F. |
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10.1007/s11060-019-03304-x |
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2024-07-03T21:30:28.923Z |
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Methods A retrospective chart review was conducted at a single high-volume cancer center for newly diagnosed elderly (65 years old or older) GBM patients diagnosed from 2011 through 2017. Results A total of 158 newly diagnosed GBM patients aged 65 years and older were identified. One hundred forty-four patients (91.1%) received radiotherapy (RT) and 130 patients (90.3%) received concurrent temozolomide with RT. Sixty-one patients (38.6%) completed concurrent chemoradiation and 6 cycles of adjuvant temozolomide. 23% of patients discontinued temozolomide during concurrent or adjuvant treatment due to side effects or complications of chemotherapy. With a median follow-up time of 35.0 months, median overall survival (OS) time for the full cohort was 18.6 months, with estimated OS rates of 74.8%, 35.9%, and 9.5% at 1, 2, and 5 years, respectively. On multivariable analysis, higher KPS (p = 0.002, HR 0.46; 95% CI 0.63–0.82), completing planned RT course (p = 0.01, HR 0.29; 95% CI 0.11–0.75), and completing 6 cycles of adjuvant temozolomide (p = 0.01, HR 2.62; 95% CI 1.67–4.12) were independently associated with improved OS. Conclusions Our cohort of elderly GBM patients was predominantly treated with standard of care therapy based on EORTC 22,981. Despite their age, these patients generally tolerated treatment well and had favorable outcomes compared to those reported for patients treated on EORTC 22,981. 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|
| score |
7.400055 |