TY - JOUR
T1 - Analysis of factors influencing the access to concomitant chemo-radiotherapy in elderly patients with high grade gliomas
T2 - role of MMSE, age and tumor volume
AU - Di Cristofori, Andrea
AU - Zarino, Barbara
AU - Fanizzi, Claudia
AU - Fornara, Giorgia Abete
AU - Bertani, Giulio
AU - Rampini, Paolo
AU - Carrabba, Giorgio
AU - Caroli, Manuela
PY - 2017/9/1
Y1 - 2017/9/1
N2 - High grade gliomas (HGG) are tumors with a rapidly progressive course and the standard of care consists of surgery and chemo-radiotherapy. Elderly patients with HGG usually have a worse prognosis due to their comorbidities and difficulties in accessing or completing adjuvant treatments. The purpose of our study was to assess the influence of pre-operative factors (MMSE, age, sex, KPS, tumor volume) on the post-operative access to chemo-radiotherapy in the elderly population. In addition, the influence of the access to adjuvant therapies on overall survival (OS) was assessed. We retrospectively reviewed our consecutive case series of 117 elderly patients (≥65 years) with HGG treated in our Institution. All the clinical records regarding age, sex, tumor location, MMSE, KPS, access to adjuvant treatments and OS were analyzed. 72 males and 45 females with a median age of 71 years were analyzed. Adjuvant therapies were considered; concomitant chemo-radiotherapy with standard radiotherapy or hypofractionated radiation regimen. 84 patients had access to adjuvant therapies. Access to therapies was associated with a median age of 71(range 66–80) years, a median MMSE of 26(range 5–30), and a median tumor volume of 24 cm3(range 1–140). The median OS was 13 months for patients who had access to adjuvant therapies and 5 months for patients who did not. In the elderly patients with HGG, the MMSE, age and tumor volume were predictive of post-surgery access to adjuvant treatments. OS was significantly longer in elderly patients with HGG who had access to post-surgery chemo-radiotherapy.
AB - High grade gliomas (HGG) are tumors with a rapidly progressive course and the standard of care consists of surgery and chemo-radiotherapy. Elderly patients with HGG usually have a worse prognosis due to their comorbidities and difficulties in accessing or completing adjuvant treatments. The purpose of our study was to assess the influence of pre-operative factors (MMSE, age, sex, KPS, tumor volume) on the post-operative access to chemo-radiotherapy in the elderly population. In addition, the influence of the access to adjuvant therapies on overall survival (OS) was assessed. We retrospectively reviewed our consecutive case series of 117 elderly patients (≥65 years) with HGG treated in our Institution. All the clinical records regarding age, sex, tumor location, MMSE, KPS, access to adjuvant treatments and OS were analyzed. 72 males and 45 females with a median age of 71 years were analyzed. Adjuvant therapies were considered; concomitant chemo-radiotherapy with standard radiotherapy or hypofractionated radiation regimen. 84 patients had access to adjuvant therapies. Access to therapies was associated with a median age of 71(range 66–80) years, a median MMSE of 26(range 5–30), and a median tumor volume of 24 cm3(range 1–140). The median OS was 13 months for patients who had access to adjuvant therapies and 5 months for patients who did not. In the elderly patients with HGG, the MMSE, age and tumor volume were predictive of post-surgery access to adjuvant treatments. OS was significantly longer in elderly patients with HGG who had access to post-surgery chemo-radiotherapy.
KW - Access to therapy
KW - Chemotherapy
KW - Elderly
KW - Elderly surgery
KW - High grade glioma
KW - KPS
KW - MMSE
KW - Overall survival
KW - Radiotherapy
UR - http://www.scopus.com/inward/record.url?scp=85021939691&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85021939691&partnerID=8YFLogxK
U2 - 10.1007/s11060-017-2537-2
DO - 10.1007/s11060-017-2537-2
M3 - Article
AN - SCOPUS:85021939691
VL - 134
SP - 377
EP - 385
JO - Journal of Neuro-Oncology
JF - Journal of Neuro-Oncology
SN - 0167-594X
IS - 2
ER -