Which elderly newly diagnosed glioblastoma patients can benefit from radiotherapy and temozolomide? A PERNO prospective study

Enrico Franceschi, R. Depenni, A. Paccapelo, M. Ermani, Marina Faedi, Carmelo Sturiale, Maria Michiara, F. Servadei, Giacomo Pavesi, Benedetta Urbini, Anna Pisanello, Girolamo Crisi, M. A. Cavallo, Claudio Dazzi, Claudia Biasini, Federica Bertolini, C. Mucciarini, Giuseppe Pasini, Agostino Baruzzi, A. BrandesMonia Dall'Agata

Research output: Contribution to journalArticle

Abstract

The role of temozolomide concurrent with and adjuvant to radiotherapy (RT/TMZ) in elderly patients with glioblastoma (GBM) remains unclear. We evaluated the outcome of patients >70 years in the context of the Project of Emilia-Romagna Region in Neuro-Oncology (PERNO), the first Italian prospective observational population-based study in neuro-oncology. For this analysis the criteria for selecting patients enrolled in the PERNO study were: age >70 years; PS 0–3; histologically confirmed GBM; postoperative radiotherapy (RT) after surgery with or without concomitant temozolomide (TMZ) or postsurgical TMZ alone. Between January 2009 and December 2010, 76 GBM elderly patients were identified in the prospective PERNO study. Twenty-three patients did not receive any treatment after surgery, and 53 patients received postsurgical treatments (25 patients received RT alone and 28 patients RT/TMZ). Median survival was 11.1 months (95 % CI 8.8–13.5), adding temozolomide concomitant and adjuvant to radiotherapy it was 11.6 months (95 % CI 8.6–14.6), and 9.3 months (95 % CI 8.1–10.6) in patients treated with RT alone (P = 0.164). However, patients with MGMT methylated treated with RT/TMZ obtained a better survival (17.2 months, 95 % CI 11.5–22.9) (P = 0.042). No difference in terms of survival were observed if patients with MGMT unmethylated tumor received RT alone, or RT/TMZ or, in MGMT methylated tumor, if patients received radiotherapy alone. In elderly patients RT/TMZ represent a widely used approach but it is effective with methylated MGMT tumors only.

Original languageEnglish
Pages (from-to)157-62
Number of pages6
JournalJournal of Neuro-Oncology
Volume128
Issue number1
DOIs
Publication statusPublished - 2016

Fingerprint

temozolomide
Glioblastoma
Radiotherapy
Prospective Studies
Adjuvant Radiotherapy
Survival

Keywords

  • Elderly
  • Glioblastoma
  • MGMT methylation
  • Radiotherapy
  • Temozolomide

ASJC Scopus subject areas

  • Clinical Neurology
  • Cancer Research
  • Oncology
  • Neurology

Cite this

Which elderly newly diagnosed glioblastoma patients can benefit from radiotherapy and temozolomide? A PERNO prospective study. / Franceschi, Enrico; Depenni, R.; Paccapelo, A.; Ermani, M.; Faedi, Marina; Sturiale, Carmelo; Michiara, Maria; Servadei, F.; Pavesi, Giacomo; Urbini, Benedetta; Pisanello, Anna; Crisi, Girolamo; Cavallo, M. A.; Dazzi, Claudio; Biasini, Claudia; Bertolini, Federica; Mucciarini, C.; Pasini, Giuseppe; Baruzzi, Agostino; Brandes, A.; Dall'Agata, Monia.

In: Journal of Neuro-Oncology, Vol. 128, No. 1, 2016, p. 157-62.

Research output: Contribution to journalArticle

Franceschi, E, Depenni, R, Paccapelo, A, Ermani, M, Faedi, M, Sturiale, C, Michiara, M, Servadei, F, Pavesi, G, Urbini, B, Pisanello, A, Crisi, G, Cavallo, MA, Dazzi, C, Biasini, C, Bertolini, F, Mucciarini, C, Pasini, G, Baruzzi, A, Brandes, A & Dall'Agata, M 2016, 'Which elderly newly diagnosed glioblastoma patients can benefit from radiotherapy and temozolomide? A PERNO prospective study', Journal of Neuro-Oncology, vol. 128, no. 1, pp. 157-62. https://doi.org/10.1007/s11060-016-2093-1
Franceschi, Enrico ; Depenni, R. ; Paccapelo, A. ; Ermani, M. ; Faedi, Marina ; Sturiale, Carmelo ; Michiara, Maria ; Servadei, F. ; Pavesi, Giacomo ; Urbini, Benedetta ; Pisanello, Anna ; Crisi, Girolamo ; Cavallo, M. A. ; Dazzi, Claudio ; Biasini, Claudia ; Bertolini, Federica ; Mucciarini, C. ; Pasini, Giuseppe ; Baruzzi, Agostino ; Brandes, A. ; Dall'Agata, Monia. / Which elderly newly diagnosed glioblastoma patients can benefit from radiotherapy and temozolomide? A PERNO prospective study. In: Journal of Neuro-Oncology. 2016 ; Vol. 128, No. 1. pp. 157-62.
@article{24dcd066b3df46bab1731839f95bd19f,
title = "Which elderly newly diagnosed glioblastoma patients can benefit from radiotherapy and temozolomide? A PERNO prospective study",
abstract = "The role of temozolomide concurrent with and adjuvant to radiotherapy (RT/TMZ) in elderly patients with glioblastoma (GBM) remains unclear. We evaluated the outcome of patients >70 years in the context of the Project of Emilia-Romagna Region in Neuro-Oncology (PERNO), the first Italian prospective observational population-based study in neuro-oncology. For this analysis the criteria for selecting patients enrolled in the PERNO study were: age >70 years; PS 0–3; histologically confirmed GBM; postoperative radiotherapy (RT) after surgery with or without concomitant temozolomide (TMZ) or postsurgical TMZ alone. Between January 2009 and December 2010, 76 GBM elderly patients were identified in the prospective PERNO study. Twenty-three patients did not receive any treatment after surgery, and 53 patients received postsurgical treatments (25 patients received RT alone and 28 patients RT/TMZ). Median survival was 11.1 months (95 {\%} CI 8.8–13.5), adding temozolomide concomitant and adjuvant to radiotherapy it was 11.6 months (95 {\%} CI 8.6–14.6), and 9.3 months (95 {\%} CI 8.1–10.6) in patients treated with RT alone (P = 0.164). However, patients with MGMT methylated treated with RT/TMZ obtained a better survival (17.2 months, 95 {\%} CI 11.5–22.9) (P = 0.042). No difference in terms of survival were observed if patients with MGMT unmethylated tumor received RT alone, or RT/TMZ or, in MGMT methylated tumor, if patients received radiotherapy alone. In elderly patients RT/TMZ represent a widely used approach but it is effective with methylated MGMT tumors only.",
keywords = "Elderly, Glioblastoma, MGMT methylation, Radiotherapy, Temozolomide",
author = "Enrico Franceschi and R. Depenni and A. Paccapelo and M. Ermani and Marina Faedi and Carmelo Sturiale and Maria Michiara and F. Servadei and Giacomo Pavesi and Benedetta Urbini and Anna Pisanello and Girolamo Crisi and Cavallo, {M. A.} and Claudio Dazzi and Claudia Biasini and Federica Bertolini and C. Mucciarini and Giuseppe Pasini and Agostino Baruzzi and A. Brandes and Monia Dall'Agata",
note = "Ricercatori distaccati presso IRCCS a seguito Convenzione esclusiva con Universit{\`a} di Bologna (Baruzzi Agostino)",
year = "2016",
doi = "10.1007/s11060-016-2093-1",
language = "English",
volume = "128",
pages = "157--62",
journal = "Journal of Neuro-Oncology",
issn = "0167-594X",
publisher = "Springer New York LLC",
number = "1",

}

TY - JOUR

T1 - Which elderly newly diagnosed glioblastoma patients can benefit from radiotherapy and temozolomide? A PERNO prospective study

AU - Franceschi, Enrico

AU - Depenni, R.

AU - Paccapelo, A.

AU - Ermani, M.

AU - Faedi, Marina

AU - Sturiale, Carmelo

AU - Michiara, Maria

AU - Servadei, F.

AU - Pavesi, Giacomo

AU - Urbini, Benedetta

AU - Pisanello, Anna

AU - Crisi, Girolamo

AU - Cavallo, M. A.

AU - Dazzi, Claudio

AU - Biasini, Claudia

AU - Bertolini, Federica

AU - Mucciarini, C.

AU - Pasini, Giuseppe

AU - Baruzzi, Agostino

AU - Brandes, A.

AU - Dall'Agata, Monia

N1 - Ricercatori distaccati presso IRCCS a seguito Convenzione esclusiva con Università di Bologna (Baruzzi Agostino)

PY - 2016

Y1 - 2016

N2 - The role of temozolomide concurrent with and adjuvant to radiotherapy (RT/TMZ) in elderly patients with glioblastoma (GBM) remains unclear. We evaluated the outcome of patients >70 years in the context of the Project of Emilia-Romagna Region in Neuro-Oncology (PERNO), the first Italian prospective observational population-based study in neuro-oncology. For this analysis the criteria for selecting patients enrolled in the PERNO study were: age >70 years; PS 0–3; histologically confirmed GBM; postoperative radiotherapy (RT) after surgery with or without concomitant temozolomide (TMZ) or postsurgical TMZ alone. Between January 2009 and December 2010, 76 GBM elderly patients were identified in the prospective PERNO study. Twenty-three patients did not receive any treatment after surgery, and 53 patients received postsurgical treatments (25 patients received RT alone and 28 patients RT/TMZ). Median survival was 11.1 months (95 % CI 8.8–13.5), adding temozolomide concomitant and adjuvant to radiotherapy it was 11.6 months (95 % CI 8.6–14.6), and 9.3 months (95 % CI 8.1–10.6) in patients treated with RT alone (P = 0.164). However, patients with MGMT methylated treated with RT/TMZ obtained a better survival (17.2 months, 95 % CI 11.5–22.9) (P = 0.042). No difference in terms of survival were observed if patients with MGMT unmethylated tumor received RT alone, or RT/TMZ or, in MGMT methylated tumor, if patients received radiotherapy alone. In elderly patients RT/TMZ represent a widely used approach but it is effective with methylated MGMT tumors only.

AB - The role of temozolomide concurrent with and adjuvant to radiotherapy (RT/TMZ) in elderly patients with glioblastoma (GBM) remains unclear. We evaluated the outcome of patients >70 years in the context of the Project of Emilia-Romagna Region in Neuro-Oncology (PERNO), the first Italian prospective observational population-based study in neuro-oncology. For this analysis the criteria for selecting patients enrolled in the PERNO study were: age >70 years; PS 0–3; histologically confirmed GBM; postoperative radiotherapy (RT) after surgery with or without concomitant temozolomide (TMZ) or postsurgical TMZ alone. Between January 2009 and December 2010, 76 GBM elderly patients were identified in the prospective PERNO study. Twenty-three patients did not receive any treatment after surgery, and 53 patients received postsurgical treatments (25 patients received RT alone and 28 patients RT/TMZ). Median survival was 11.1 months (95 % CI 8.8–13.5), adding temozolomide concomitant and adjuvant to radiotherapy it was 11.6 months (95 % CI 8.6–14.6), and 9.3 months (95 % CI 8.1–10.6) in patients treated with RT alone (P = 0.164). However, patients with MGMT methylated treated with RT/TMZ obtained a better survival (17.2 months, 95 % CI 11.5–22.9) (P = 0.042). No difference in terms of survival were observed if patients with MGMT unmethylated tumor received RT alone, or RT/TMZ or, in MGMT methylated tumor, if patients received radiotherapy alone. In elderly patients RT/TMZ represent a widely used approach but it is effective with methylated MGMT tumors only.

KW - Elderly

KW - Glioblastoma

KW - MGMT methylation

KW - Radiotherapy

KW - Temozolomide

UR - http://www.scopus.com/inward/record.url?scp=84960094715&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84960094715&partnerID=8YFLogxK

U2 - 10.1007/s11060-016-2093-1

DO - 10.1007/s11060-016-2093-1

M3 - Article

C2 - 26943851

VL - 128

SP - 157

EP - 162

JO - Journal of Neuro-Oncology

JF - Journal of Neuro-Oncology

SN - 0167-594X

IS - 1

ER -