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Adjuvant radiation in older patients with glioblastoma: a retrospective single institution analysis

Lee, Jessica W, Kirkpatrick, John P, McSherry, Frances, Herndon, James E, Lipp, Eric S, Desjardins, Annick, Randazzo, Dina M, Friedman, Henry S, Ashley, David M, Peters, Katherine B and Johnson, Margaret O 2021, Adjuvant radiation in older patients with glioblastoma: a retrospective single institution analysis, Frontiers in oncology, vol. 11, pp. 1-7, doi: 10.3389/fonc.2021.631618.

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Title Adjuvant radiation in older patients with glioblastoma: a retrospective single institution analysis
Author(s) Lee, Jessica W
Kirkpatrick, John P
McSherry, Frances
Herndon, James E
Lipp, Eric S
Desjardins, Annick
Randazzo, Dina M
Friedman, Henry S
Ashley, David M
Peters, Katherine B
Johnson, Margaret O
Journal name Frontiers in oncology
Volume number 11
Article ID 631618
Start page 1
End page 7
Total pages 7
Publisher Frontiers Research Foundation
Place of publication Lausanne, Switzerland
Publication date 2021-02
ISSN 2234-943X
2234-943X
Keyword(s) aged
frail elderly
glioblastoma
radiation dose hypofractionation
radiation oncology
radiotherapy
Life Sciences & Biomedicine
Oncology
Science & Technology
Summary Objectives Standard 6-week and hypofractionated 3-week courses of adjuvant radiation therapy (RT) are both options for older patients with glioblastoma (GBM), but deciding the optimal regimen can be challenging. This analysis explores clinical factors associated with selection of RT course, completion of RT, and outcomes following RT. Materials and Methods This IRB-approved retrospective analysis identified patients ≥70 years old with GBM who initiated adjuvant RT at our institution between 2004 and 2016. We identified factors associated with standard or hypofractionated RT using the Cochran-Armitage trend test, estimated time-to-event endpoints using the Kaplan-Meier method, and found predictors of overall survival (OS) using Cox proportional hazards models. Results Sixty-two patients with a median age of 74 (range 70–90) initiated adjuvant RT, with 43 (69%) receiving standard RT and 19 (31%) receiving hypofractionated RT. Selection of short-course RT was associated with older age (p = 0.04) and poor KPS (p = 0.03). Eight (13%) patients did not complete RT, primarily for hospice care due to worsening symptoms. After a median follow-up of 37 months, median OS was 12.3 months (95% CI 9.0–15.1). Increased age (p < 0.05), poor KPS (p < 0.0001), lack of MGMT methylation (p < 0.05), and lack of RT completion (p < 0.0001) were associated with worse OS on multivariate analysis. In this small cohort, GTV size and receipt of standard or hypofractionated RT were not associated with OS. Conclusions In this cohort of older patients with GBM, age and KPS was associated with selection of short-course or standard RT. These regimens had similar OS, though a subset of patients experienced worsening symptoms during RT and discontinued treatment. Further investigation into predictors of RT completion and survival may help guide adjuvant therapies and supportive care for older patients.
Language eng
DOI 10.3389/fonc.2021.631618
Indigenous content off
Field of Research 1112 Oncology and Carcinogenesis
HERDC Research category C1 Refereed article in a scholarly journal
Free to Read? Yes
Persistent URL http://hdl.handle.net/10536/DRO/DU:30149761

Document type: Journal Article
Collections: Faculty of Health
School of Medicine
Open Access Collection
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.