Skip to main content
Top
Published in: Medical Oncology 5/2012

01-12-2012 | Original Paper

Comorbidity assessment and adjuvant radiochemotherapy in elderly affected by glioblastoma

Authors: Alba Fiorentino, Rocchina Caivano, Costanza Chiumento, Mariella Cozzolino, Stefania Clemente, Piernicola Pedicini, Vincenzo Fusco

Published in: Medical Oncology | Issue 5/2012

Login to get access

Abstract

To assess the role of comorbidity on outcome in elderly patients with glioblastoma treated with radiotherapy plus concomitant and adjuvant Temozolomide, patients over 65 years with glioblastoma, who underwent surgical resection or biopsy and radiochemotherapy, were evaluated. The Adjusted-Age Charlson Comorbidity Index and the Adult Comorbidity Evaluation-27 were used to assess comorbidity. From April 2005 to January 2011, 35 patients (median age 72 years) were treated in our Institution. Thirteen patients had a Charlson score more than 3, while, according to the Adult Comorbidity Evaluation-27, 21 patients had mild or severe comorbid conditions. Patients with low Charlson comorbidity score experienced a longer survival time than those with higher score (22 vs. 10 months, respectively). The Adjusted-Age Charlson Comorbidity Index influenced survival at univariate and multivariate analysis (p = 0.004, p = 0.001, respectively). No comorbidity index was a predictor for progression-free survival. Our data suggested that the association of radiotherapy with TMZ was safe and effective. Perhaps, the comorbidity assessment could be an appropriate tool in the treatment decision for elderly patients with glioblastoma.
Literature
2.
go back to reference Stupp R, Mason W, Van der Bent M, et al. Radiotherapy plus concomitant and adjuvant Temozolomide for glioblastoma. N Engl J Med. 2005;352:987–96.PubMedCrossRef Stupp R, Mason W, Van der Bent M, et al. Radiotherapy plus concomitant and adjuvant Temozolomide for glioblastoma. N Engl J Med. 2005;352:987–96.PubMedCrossRef
3.
go back to reference Stupp R, Hegi ME, Mason WP, et al. Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomized phase III study: 5-years analysis of the EORTC-NCIC trial. Lancet Oncol. 2009;10:459–66.PubMedCrossRef Stupp R, Hegi ME, Mason WP, et al. Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomized phase III study: 5-years analysis of the EORTC-NCIC trial. Lancet Oncol. 2009;10:459–66.PubMedCrossRef
4.
go back to reference Fischer JL, et al. Epidemiology of brain tumors. Neurol Clin. 2007;25:867–90.CrossRef Fischer JL, et al. Epidemiology of brain tumors. Neurol Clin. 2007;25:867–90.CrossRef
5.
go back to reference Curran WJ Jr, Scott CB, Horton J, et al. Recursive partitioning analysis of prognostic factors in three radiation therapy oncology group malignant glioma trials. J Natl Cancer Inst. 1993;85:704–10.PubMedCrossRef Curran WJ Jr, Scott CB, Horton J, et al. Recursive partitioning analysis of prognostic factors in three radiation therapy oncology group malignant glioma trials. J Natl Cancer Inst. 1993;85:704–10.PubMedCrossRef
6.
go back to reference Simpson JR, Horton J, Scott C, et al. Influence of location and extent of surgical resection on survival of patients with glioblastoma multiforme: results of three consecutive Radiation Therapy Oncology Group (RTOG) clinical trials. Int J Radiat Oncol Biol Phys. 2003;26:239–44.CrossRef Simpson JR, Horton J, Scott C, et al. Influence of location and extent of surgical resection on survival of patients with glioblastoma multiforme: results of three consecutive Radiation Therapy Oncology Group (RTOG) clinical trials. Int J Radiat Oncol Biol Phys. 2003;26:239–44.CrossRef
7.
go back to reference Yovino S, Grossman SA. Treatment of glioblastoma in “elderly” patients. Curr Treat Opin Oncol. 2011;12:253–62.CrossRef Yovino S, Grossman SA. Treatment of glioblastoma in “elderly” patients. Curr Treat Opin Oncol. 2011;12:253–62.CrossRef
8.
go back to reference Fiorentino A, Chiumento C, Caivano R et al. Adjuvant radiochemotherapy in elderly patients with Glioblastoma: single institution experience and review of the literature. Radiol Med. 2012 (in press). Fiorentino A, Chiumento C, Caivano R et al. Adjuvant radiochemotherapy in elderly patients with Glioblastoma: single institution experience and review of the literature. Radiol Med. 2012 (in press).
9.
go back to reference Iwamoto FM, Cooper AR, Reiner AS, et al. Glioblastoma in elderly: the Memorial Sloan-Kettering Cancer Center experience (1997–2007). Cancer. 2009;16:3758–66.CrossRef Iwamoto FM, Cooper AR, Reiner AS, et al. Glioblastoma in elderly: the Memorial Sloan-Kettering Cancer Center experience (1997–2007). Cancer. 2009;16:3758–66.CrossRef
10.
go back to reference Daskivich TJ, Chamie K, Kwan L, Labo J, Palvolgyi R, Dash A, Greenfield S, Litwin MS. Overtreatment of men with low-risk prostate cancer and significant comorbidity. Cancer. 2011;117(10):2058–66.PubMedCrossRef Daskivich TJ, Chamie K, Kwan L, Labo J, Palvolgyi R, Dash A, Greenfield S, Litwin MS. Overtreatment of men with low-risk prostate cancer and significant comorbidity. Cancer. 2011;117(10):2058–66.PubMedCrossRef
11.
go back to reference Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373–83.PubMedCrossRef Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373–83.PubMedCrossRef
12.
go back to reference Piccirillo JF, Tierney RM, Costas I, Grove L, Spitznagel EL Jr. Prognostic importance of co-morbidity in a hospital-based cancer registry. J Am Med Assoc. 2004;291:2441–7.CrossRef Piccirillo JF, Tierney RM, Costas I, Grove L, Spitznagel EL Jr. Prognostic importance of co-morbidity in a hospital-based cancer registry. J Am Med Assoc. 2004;291:2441–7.CrossRef
13.
go back to reference Fiorica F, Berretta M, Colosimo C, et al. Glioblastoma in elderly patients: safety and efficacy of adjuvant radiotherapy with concomitant temozolomide. Arch Gerontol Geriatr. 2010;51(1):31–5.PubMedCrossRef Fiorica F, Berretta M, Colosimo C, et al. Glioblastoma in elderly patients: safety and efficacy of adjuvant radiotherapy with concomitant temozolomide. Arch Gerontol Geriatr. 2010;51(1):31–5.PubMedCrossRef
14.
go back to reference Clogh-Gorr KM, Stuck AE, Thwin SS. Older breast cancer survivors: geriatric assessment domains are associated with poor tolerance of treatment adverse effects and predict mortality over 7 years of follow-up. J Clin Oncol. 2010;28(3):380–6.CrossRef Clogh-Gorr KM, Stuck AE, Thwin SS. Older breast cancer survivors: geriatric assessment domains are associated with poor tolerance of treatment adverse effects and predict mortality over 7 years of follow-up. J Clin Oncol. 2010;28(3):380–6.CrossRef
15.
go back to reference Kopek N, Paludan M, Petersen J, Hansen AT, Grau C, Høyer M. Comorbidity index predicts for mortality after stereotacticbody radiotherapy for medical inoperable early stage non-small cell lung cancer. Radiother Oncol. 2009;93(3):402–7.PubMedCrossRef Kopek N, Paludan M, Petersen J, Hansen AT, Grau C, Høyer M. Comorbidity index predicts for mortality after stereotacticbody radiotherapy for medical inoperable early stage non-small cell lung cancer. Radiother Oncol. 2009;93(3):402–7.PubMedCrossRef
16.
go back to reference Fiorentino A, Chiesa S, De Bonis P et al. Impact of Temozolomide and Radiation Therapy in elderly patients affected by glioblastoma: A pooled analysis of 3 prospectic phase II trials. J Clin Oncol. 2010;28:7s (abstr 2070). Fiorentino A, Chiesa S, De Bonis P et al. Impact of Temozolomide and Radiation Therapy in elderly patients affected by glioblastoma: A pooled analysis of 3 prospectic phase II trials. J Clin Oncol. 2010;28:7s (abstr 2070).
17.
go back to reference Therasse P, Arbuck SG, Eisenhauer EA, et al. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst. 2000;92:205–16.PubMedCrossRef Therasse P, Arbuck SG, Eisenhauer EA, et al. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst. 2000;92:205–16.PubMedCrossRef
18.
go back to reference Balducci M, D’Agostino GR, Manfrida S, et al. Radiotherapy and concomitant temozolomide during the first and last weeks in high grade gliomas: long-term analysis of a phase II study. J Neurooncol. 2010;97(1):95–100.PubMedCrossRef Balducci M, D’Agostino GR, Manfrida S, et al. Radiotherapy and concomitant temozolomide during the first and last weeks in high grade gliomas: long-term analysis of a phase II study. J Neurooncol. 2010;97(1):95–100.PubMedCrossRef
19.
20.
go back to reference Irminger-Finger I. Science of cancer and aging. J Clin Oncol. 1844;2007(25):51. Irminger-Finger I. Science of cancer and aging. J Clin Oncol. 1844;2007(25):51.
21.
go back to reference Gomez-Millan J. Radiation therapy in the elderly: more side effects and complications? Crit Rev Oncol Hematol. 2009;71:70–8.PubMedCrossRef Gomez-Millan J. Radiation therapy in the elderly: more side effects and complications? Crit Rev Oncol Hematol. 2009;71:70–8.PubMedCrossRef
22.
go back to reference Yancik R, Havlik RJ, Wesley MN, et al. Cancer and co-morbidity in older patients: a descriptive profile. Ann Epidemiol. 1996;6(5):399–412.PubMedCrossRef Yancik R, Havlik RJ, Wesley MN, et al. Cancer and co-morbidity in older patients: a descriptive profile. Ann Epidemiol. 1996;6(5):399–412.PubMedCrossRef
23.
go back to reference Djunic I, Virijevic M, Novkovic A et al. Comorbidity as a risk factor for overall survival and decision criteria for intensity of chemotherapy in elderly patients with acute myeloid leukemia. Med Oncol. 2011. doi:10.1007/s12032-011-9853-8. Djunic I, Virijevic M, Novkovic A et al. Comorbidity as a risk factor for overall survival and decision criteria for intensity of chemotherapy in elderly patients with acute myeloid leukemia. Med Oncol. 2011. doi:10.​1007/​s12032-011-9853-8.
24.
go back to reference Fiorica F, Berretta M, Colosimo C, et al. Safety and efficacy in radiotherapy treatment in elderly patients with localized prostate cancer: a retrospective analysis. Arch Geron Geriatr. 2010;51:277–82.CrossRef Fiorica F, Berretta M, Colosimo C, et al. Safety and efficacy in radiotherapy treatment in elderly patients with localized prostate cancer: a retrospective analysis. Arch Geron Geriatr. 2010;51:277–82.CrossRef
25.
go back to reference Peters TT, van der Laan BF, Plaat BE, Wedman J, Langendijk JA, Halmos GB. Impact of comorbidity on treatment-relate side effects in older patients with laryngeal cancer. Oral Oncol. 2011;47(1):56–61.PubMedCrossRef Peters TT, van der Laan BF, Plaat BE, Wedman J, Langendijk JA, Halmos GB. Impact of comorbidity on treatment-relate side effects in older patients with laryngeal cancer. Oral Oncol. 2011;47(1):56–61.PubMedCrossRef
26.
go back to reference Chiumento C, Fiorentino A, Caivano R, Clemente S, Fusco V. Prostate low-dose rate Brachytherapy in elderly patients. Radiol Med. 2012 (in press). Chiumento C, Fiorentino A, Caivano R, Clemente S, Fusco V. Prostate low-dose rate Brachytherapy in elderly patients. Radiol Med. 2012 (in press).
27.
go back to reference Brandes AA, Franceschi E, Tosoni A, et al. Temozolomide concomitant and adjuvant to radiotherapy in elderly patients with glioblastoma: correlation with MGMT promoter methylation status. Cancer. 2009;115:3512–8.PubMedCrossRef Brandes AA, Franceschi E, Tosoni A, et al. Temozolomide concomitant and adjuvant to radiotherapy in elderly patients with glioblastoma: correlation with MGMT promoter methylation status. Cancer. 2009;115:3512–8.PubMedCrossRef
28.
go back to reference Gerstein J, Franz K, Steinbach JP, et al. Postoperative radiotherapy and concomitant Temozolomide for elderly patients with glioblastoma. Radiother Oncol. 2010;97(3):382–6.PubMedCrossRef Gerstein J, Franz K, Steinbach JP, et al. Postoperative radiotherapy and concomitant Temozolomide for elderly patients with glioblastoma. Radiother Oncol. 2010;97(3):382–6.PubMedCrossRef
29.
go back to reference Keim-Guibert F, Chinot O, Taillandier L, et al. Radiotherapy for glioblastoma in elderly. N Engl J Med. 2007;356:1527–35.CrossRef Keim-Guibert F, Chinot O, Taillandier L, et al. Radiotherapy for glioblastoma in elderly. N Engl J Med. 2007;356:1527–35.CrossRef
30.
go back to reference Glantz M, Chamberlain M, Liu Q, Litofsky NS, Recht LD. Temozolomide as an alternative to irradiation for elderly patients with new diagnosed malignant gliomas. Cancer. 2003;97(9):2262–6.PubMedCrossRef Glantz M, Chamberlain M, Liu Q, Litofsky NS, Recht LD. Temozolomide as an alternative to irradiation for elderly patients with new diagnosed malignant gliomas. Cancer. 2003;97(9):2262–6.PubMedCrossRef
Metadata
Title
Comorbidity assessment and adjuvant radiochemotherapy in elderly affected by glioblastoma
Authors
Alba Fiorentino
Rocchina Caivano
Costanza Chiumento
Mariella Cozzolino
Stefania Clemente
Piernicola Pedicini
Vincenzo Fusco
Publication date
01-12-2012
Publisher
Springer US
Published in
Medical Oncology / Issue 5/2012
Print ISSN: 1357-0560
Electronic ISSN: 1559-131X
DOI
https://doi.org/10.1007/s12032-012-0246-4

Other articles of this Issue 5/2012

Medical Oncology 5/2012 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine