Treatment Strategies for Glioblastoma in the Elderly: What Should We Focus on Compared to Younger Patients.

Autor: Gull HH; Department of Neurosurgery and Spine Surgery, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany.; Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, 45147 Essen, Germany.; DKFZ-Division Translational Neurooncology at the WTZ, DKTK Partner Site, University Hospital Essen, 45147 Essen, Germany.; West German Cancer Center (WTZ), University Hospital Essen, 45147 Essen, Germany., Von Riegen AC; Department of Neurosurgery and Spine Surgery, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany., Beckmann GT; Department of Neurosurgery and Spine Surgery, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany., Ketelauri P; Department of Neurosurgery and Spine Surgery, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany.; Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, 45147 Essen, Germany., Walbrodt S; Department of Neurosurgery and Spine Surgery, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany.; Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, 45147 Essen, Germany., Santos AN; Department of Neurosurgery and Spine Surgery, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany.; Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, 45147 Essen, Germany., Oster C; DKFZ-Division Translational Neurooncology at the WTZ, DKTK Partner Site, University Hospital Essen, 45147 Essen, Germany.; West German Cancer Center (WTZ), University Hospital Essen, 45147 Essen, Germany.; Department of Neurology, Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Division of Clinical Neurooncology, University Medicine Essen, University of Duisburg-Essen, 45147 Essen, Germany., Schmidt T; DKFZ-Division Translational Neurooncology at the WTZ, DKTK Partner Site, University Hospital Essen, 45147 Essen, Germany.; West German Cancer Center (WTZ), University Hospital Essen, 45147 Essen, Germany.; Department of Neurology, Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Division of Clinical Neurooncology, University Medicine Essen, University of Duisburg-Essen, 45147 Essen, Germany., Glas M; Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, 45147 Essen, Germany.; DKFZ-Division Translational Neurooncology at the WTZ, DKTK Partner Site, University Hospital Essen, 45147 Essen, Germany.; West German Cancer Center (WTZ), University Hospital Essen, 45147 Essen, Germany.; Department of Neurology, Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Division of Clinical Neurooncology, University Medicine Essen, University of Duisburg-Essen, 45147 Essen, Germany., Jabbarli R; Department of Neurosurgery and Spine Surgery, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany.; Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, 45147 Essen, Germany., Özkan N; Department of Neurosurgery and Spine Surgery, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany.; Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, 45147 Essen, Germany., Dammann P; Department of Neurosurgery and Spine Surgery, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany.; Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, 45147 Essen, Germany., Scheffler B; DKFZ-Division Translational Neurooncology at the WTZ, DKTK Partner Site, University Hospital Essen, 45147 Essen, Germany.; West German Cancer Center (WTZ), University Hospital Essen, 45147 Essen, Germany.; German Cancer Consortium (DKTK), 69120 Heidelberg, Germany.; German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany.; Center of Medical Biotechnology (ZMB), University of Duisburg-Essen, 45147 Essen, Germany., Sure U; Department of Neurosurgery and Spine Surgery, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany.; Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, 45147 Essen, Germany., Ahmadipour Y; Department of Neurosurgery and Spine Surgery, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany.; Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, 45147 Essen, Germany.; DKFZ-Division Translational Neurooncology at the WTZ, DKTK Partner Site, University Hospital Essen, 45147 Essen, Germany.; West German Cancer Center (WTZ), University Hospital Essen, 45147 Essen, Germany.
Jazyk: angličtina
Zdroj: Cancers [Cancers (Basel)] 2024 Mar 21; Vol. 16 (6). Date of Electronic Publication: 2024 Mar 21.
DOI: 10.3390/cancers16061231
Abstrakt: (1) Background: Although the incidence of glioblastoma (GB) has a peak in patients aged 75-84 years, no standard treatment regimen for elderly patients has been established so far. The goal of this study was to analyze the outcome of GB patients ≥ 65 years to detect predictors with relevant impacts on overall survival (OS) and progression-free survival (PFS). (2) Methods: Medical records referred to our institution from 2006 to 2020 were analyzed. Adult GB patients with clinical data, postoperative MRI data, and ≥1 follow-up investigation after surgical resection were included. The complete cohort was divided into a younger (<65) and an elderly group (≥65 years). Multiple factors regarding OS and PFS were scanned using univariate and multivariable regression with p < 0.05. (3) Results: 1004 patients were included with 322 (61.0%) male individuals in the younger and 267 (56.1%) males in the older cohort. The most common tumor localization was frontal in both groups. Gross total resection (GTR) was the most common surgical procedure in both groups, followed by subtotal resection (STR) (145; 27.5%) in the younger group, and biopsy (156; 32.8%) in the elderly group. Multivariate analyses detected that in the younger cohort, MGMT promoter methylation and GTR were predictors for a longer OS, while MGMT methylation, GTR, and hypofractionated radiation were significantly associated with a longer OS in the elderly group. (4) Conclusions: Elderly patients benefit from surgical resection of GB when they show MGMT promoter methylation, undergo GTR, and receive hypofractionated radiation. Furthermore, MGMT methylation seems to be associated with a longer PFS in elderly patients. Further investigations are required to confirm these findings, especially within prospective radiation therapy studies and molecular examinations.
Databáze: MEDLINE
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