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Background Glioblastoma (GB) is the most common malignant CNS tumor. Incidence ingreases with age, peaking between 69 and 84 yers, and half of patients diagnosed have > 65 years. The question about how to treat these patients remains object of controversy. The purpose of this survey was to know the treatment recommendations for BG in academic Spanish hospitals. Methods In 2018, surveys were e-mailed to all members of GEINO (Spanish Group for Neurooncology Reseach). The survey contained specific questions on the routine clinical practice regarding treatment recommendations for elderly patients with GB and anaplastic astrocytoma in different clinical situations: depending on ECOG, morbility, MGMT promoter methylation, age intervals (between 65-70 y, 70-80 y, >80 y). Response options were: a) Stupp regimen, b) Perry regimen, c) Radiation or TMZ depending on MGMT status and d) supportive care. Participants were also asked if they used MGMT status to select patients for Stupp or Perry regimen. Results Twenty-six neuro-oncoligist from twenty-six hospitals completed the survey. Mean of hospital beds of the institutions were 833.19 (range 150-1500). Mean of hospital veds of the instituions were 833,19 (range 150-1500). Median number of new cases treated per year were 31 (range 8-80). In patients with ECOG 0-1 and between 65 and 70 years old, 80.8 % of participants would recommend treatment with Stupp regiment. For patients with ECOG 0-1 and between 70-80; 46.2 % recommenden Perry regimen in methylated (M) and unmethylated (UM) patients; 38.5 % recommended Stupp regimen in both. For with ECOG 0-1 and > 80 % yo, 46,2 % recommend Perry regimen in both M and UM; 3.8 % Stupp regimen; 15,4 % radiation or TMZ according to MGMT status. In patients with anaplastic astrocytoma aged 70-80 y, 46,2 % would recommend Perry regimen and 42,3 % Stupp regimen. Table: 411P . Most recommend treatment Percentage of responders Glioblastoma, age 70-80 (PS 0-1, minor comorbility) Perry Stupp 46.2 % 38.5 % Glioblastoma, age >80 (PS 0-1, mior comorbility Perry 46.2 % Glioblastoma, age 65-70 (PS 0-1, minor comorbility) Stupp 80.8 % Glioblastoma, no MGMT methylation 70-80 >80 65-70 Stupp Perry Stupp 50 % 34.6 % 68.5 % Glioblastoma >65, PS > 2 Stupp 36.8 % Anaplastic astrocytoma 70-80 yo Perry 30.8 % Anaplastic astrocytoma >80 Perry 34.6 % Anaplastic astrocytoma 65-70 Stupp 53.8 % Conclusions Our research demonstrates there is no uniform approach to the management of elderly patient with glioblastoma among academic neuro-oncologist. Legal entity responsible for the study GEINO (Grupo Espanol de Investigacion en Neurooncologia). Funding Has not received any funding. Disclosure M. Vaz Salgado: Advisory / Consultancy, Travel / Accommodation / Expenses: Pharmamar; Advisory / Consultancy: Lilly, Eisai y Celgene; Research grant / Funding (self): Pfizer. M. Vieito Villar: Travel / Accommodation / Expenses: Roche. R. Luque: Honoraria (self), Travel / Accommodation / Expenses: Janssen-Cilag; Honoraria (self), Travel / Accommodation / Expenses: Sanofi Aventis; Honoraria (self), Travel / Accommodation / Expenses: Astellas Medivation; Honoraria (self), Travel / Accommodation / Expenses: Roche; Honoraria (self), Travel / Accommodation / Expenses: Novartis; Honoraria (self), Travel / Accommodation / Expenses: Pfizer; Honoraria (self), Travel / Accommodation / Expenses: Bristol Mayers Squibb; Honoraria (self), Travel / Accommodation / Expenses: EUSA Pharma. All other authors have declared no conflicts of interest. |
