Toxicity from chemoradiotherapy in older patients with glioblastoma multiforme

Angelique E. Sijben, John B. McIntyre, Gloria B. Roldán, Jacob C. Easaw, Elizabeth Yan, Peter A. Forsyth, Ian F Parney, Anthony M. Magliocco, Hans Bernsen, J. Gregory Cairncross

Research output: Contribution to journalArticle

100 Citations (Scopus)

Abstract

Introduction: Elderly patients have glioblastomas (GBM) that are aggressive and poorly responsive to treatment. They are also prone to the side effects of treatment of GBM. Methods: To shed light on the treatment of elderly patients with GBM, we reviewed the treatment toxicities and survival of patients 65 years of age or older who were treated with chemoradiotherapy, which is the new standard of care for GBM in younger patients. Results: Thirty-nine patients at a single cancer center in Canada met the eligibility criteria for this retrospective study. Nineteen patients were treated initially with TMZ and radiotherapy and 20 others were treated with radiotherapy alone (only two had TMZ subsequently). Eight patients in the chemoradiotherapy group (42%) experienced Grade III or IV toxicity versus none in the radiotherapy group. The median overall survival in the chemoradiotherapy group was 8.5 months (range, 2.0-24.7 months) versus 5.2 months (range, 1.5-14.2 months) in the radiotherapy group, an apparent benefit which may have been due to an imbalance in age at diagnosis, extent of resection and performance status. In this series of GBM cases, methylation of the MGMT gene promoter was not associated with longer survival, either overall, or within the chemoradiotherapy treated subset. Conclusions: Elderly patients with GBM treated with chemoradiotherapy can be expected to experience significant toxicity. Large randomized trials will be necessary to determine whether chemoradiotherapy prolongs the survival of elderly patients and whether MGMT promoter status predicts benefit from temozolomide in this subset of patients.

Original languageEnglish (US)
Pages (from-to)97-103
Number of pages7
JournalJournal of Neuro-Oncology
Volume89
Issue number1
DOIs
StatePublished - Aug 2008
Externally publishedYes

Fingerprint

Chemoradiotherapy
Glioblastoma
Radiotherapy
Survival
temozolomide
Therapeutics
Standard of Care
Methylation
Canada
Retrospective Studies

Keywords

  • Chemoradiotherapy
  • Elderly patients
  • Glioblastoma
  • Toxicity

ASJC Scopus subject areas

  • Clinical Neurology
  • Cancer Research
  • Oncology
  • Neuroscience(all)

Cite this

Sijben, A. E., McIntyre, J. B., Roldán, G. B., Easaw, J. C., Yan, E., Forsyth, P. A., ... Cairncross, J. G. (2008). Toxicity from chemoradiotherapy in older patients with glioblastoma multiforme. Journal of Neuro-Oncology, 89(1), 97-103. https://doi.org/10.1007/s11060-008-9593-6

Toxicity from chemoradiotherapy in older patients with glioblastoma multiforme. / Sijben, Angelique E.; McIntyre, John B.; Roldán, Gloria B.; Easaw, Jacob C.; Yan, Elizabeth; Forsyth, Peter A.; Parney, Ian F; Magliocco, Anthony M.; Bernsen, Hans; Cairncross, J. Gregory.

In: Journal of Neuro-Oncology, Vol. 89, No. 1, 08.2008, p. 97-103.

Research output: Contribution to journalArticle

Sijben, AE, McIntyre, JB, Roldán, GB, Easaw, JC, Yan, E, Forsyth, PA, Parney, IF, Magliocco, AM, Bernsen, H & Cairncross, JG 2008, 'Toxicity from chemoradiotherapy in older patients with glioblastoma multiforme', Journal of Neuro-Oncology, vol. 89, no. 1, pp. 97-103. https://doi.org/10.1007/s11060-008-9593-6
Sijben AE, McIntyre JB, Roldán GB, Easaw JC, Yan E, Forsyth PA et al. Toxicity from chemoradiotherapy in older patients with glioblastoma multiforme. Journal of Neuro-Oncology. 2008 Aug;89(1):97-103. https://doi.org/10.1007/s11060-008-9593-6
Sijben, Angelique E. ; McIntyre, John B. ; Roldán, Gloria B. ; Easaw, Jacob C. ; Yan, Elizabeth ; Forsyth, Peter A. ; Parney, Ian F ; Magliocco, Anthony M. ; Bernsen, Hans ; Cairncross, J. Gregory. / Toxicity from chemoradiotherapy in older patients with glioblastoma multiforme. In: Journal of Neuro-Oncology. 2008 ; Vol. 89, No. 1. pp. 97-103.
@article{c6426e12b47f4593a8e4dffe1bc86f68,
title = "Toxicity from chemoradiotherapy in older patients with glioblastoma multiforme",
abstract = "Introduction: Elderly patients have glioblastomas (GBM) that are aggressive and poorly responsive to treatment. They are also prone to the side effects of treatment of GBM. Methods: To shed light on the treatment of elderly patients with GBM, we reviewed the treatment toxicities and survival of patients 65 years of age or older who were treated with chemoradiotherapy, which is the new standard of care for GBM in younger patients. Results: Thirty-nine patients at a single cancer center in Canada met the eligibility criteria for this retrospective study. Nineteen patients were treated initially with TMZ and radiotherapy and 20 others were treated with radiotherapy alone (only two had TMZ subsequently). Eight patients in the chemoradiotherapy group (42{\%}) experienced Grade III or IV toxicity versus none in the radiotherapy group. The median overall survival in the chemoradiotherapy group was 8.5 months (range, 2.0-24.7 months) versus 5.2 months (range, 1.5-14.2 months) in the radiotherapy group, an apparent benefit which may have been due to an imbalance in age at diagnosis, extent of resection and performance status. In this series of GBM cases, methylation of the MGMT gene promoter was not associated with longer survival, either overall, or within the chemoradiotherapy treated subset. Conclusions: Elderly patients with GBM treated with chemoradiotherapy can be expected to experience significant toxicity. Large randomized trials will be necessary to determine whether chemoradiotherapy prolongs the survival of elderly patients and whether MGMT promoter status predicts benefit from temozolomide in this subset of patients.",
keywords = "Chemoradiotherapy, Elderly patients, Glioblastoma, Toxicity",
author = "Sijben, {Angelique E.} and McIntyre, {John B.} and Rold{\'a}n, {Gloria B.} and Easaw, {Jacob C.} and Elizabeth Yan and Forsyth, {Peter A.} and Parney, {Ian F} and Magliocco, {Anthony M.} and Hans Bernsen and Cairncross, {J. Gregory}",
year = "2008",
month = "8",
doi = "10.1007/s11060-008-9593-6",
language = "English (US)",
volume = "89",
pages = "97--103",
journal = "Journal of Neuro-Oncology",
issn = "0167-594X",
publisher = "Kluwer Academic Publishers",
number = "1",

}

TY - JOUR

T1 - Toxicity from chemoradiotherapy in older patients with glioblastoma multiforme

AU - Sijben, Angelique E.

AU - McIntyre, John B.

AU - Roldán, Gloria B.

AU - Easaw, Jacob C.

AU - Yan, Elizabeth

AU - Forsyth, Peter A.

AU - Parney, Ian F

AU - Magliocco, Anthony M.

AU - Bernsen, Hans

AU - Cairncross, J. Gregory

PY - 2008/8

Y1 - 2008/8

N2 - Introduction: Elderly patients have glioblastomas (GBM) that are aggressive and poorly responsive to treatment. They are also prone to the side effects of treatment of GBM. Methods: To shed light on the treatment of elderly patients with GBM, we reviewed the treatment toxicities and survival of patients 65 years of age or older who were treated with chemoradiotherapy, which is the new standard of care for GBM in younger patients. Results: Thirty-nine patients at a single cancer center in Canada met the eligibility criteria for this retrospective study. Nineteen patients were treated initially with TMZ and radiotherapy and 20 others were treated with radiotherapy alone (only two had TMZ subsequently). Eight patients in the chemoradiotherapy group (42%) experienced Grade III or IV toxicity versus none in the radiotherapy group. The median overall survival in the chemoradiotherapy group was 8.5 months (range, 2.0-24.7 months) versus 5.2 months (range, 1.5-14.2 months) in the radiotherapy group, an apparent benefit which may have been due to an imbalance in age at diagnosis, extent of resection and performance status. In this series of GBM cases, methylation of the MGMT gene promoter was not associated with longer survival, either overall, or within the chemoradiotherapy treated subset. Conclusions: Elderly patients with GBM treated with chemoradiotherapy can be expected to experience significant toxicity. Large randomized trials will be necessary to determine whether chemoradiotherapy prolongs the survival of elderly patients and whether MGMT promoter status predicts benefit from temozolomide in this subset of patients.

AB - Introduction: Elderly patients have glioblastomas (GBM) that are aggressive and poorly responsive to treatment. They are also prone to the side effects of treatment of GBM. Methods: To shed light on the treatment of elderly patients with GBM, we reviewed the treatment toxicities and survival of patients 65 years of age or older who were treated with chemoradiotherapy, which is the new standard of care for GBM in younger patients. Results: Thirty-nine patients at a single cancer center in Canada met the eligibility criteria for this retrospective study. Nineteen patients were treated initially with TMZ and radiotherapy and 20 others were treated with radiotherapy alone (only two had TMZ subsequently). Eight patients in the chemoradiotherapy group (42%) experienced Grade III or IV toxicity versus none in the radiotherapy group. The median overall survival in the chemoradiotherapy group was 8.5 months (range, 2.0-24.7 months) versus 5.2 months (range, 1.5-14.2 months) in the radiotherapy group, an apparent benefit which may have been due to an imbalance in age at diagnosis, extent of resection and performance status. In this series of GBM cases, methylation of the MGMT gene promoter was not associated with longer survival, either overall, or within the chemoradiotherapy treated subset. Conclusions: Elderly patients with GBM treated with chemoradiotherapy can be expected to experience significant toxicity. Large randomized trials will be necessary to determine whether chemoradiotherapy prolongs the survival of elderly patients and whether MGMT promoter status predicts benefit from temozolomide in this subset of patients.

KW - Chemoradiotherapy

KW - Elderly patients

KW - Glioblastoma

KW - Toxicity

UR - http://www.scopus.com/inward/record.url?scp=46949100273&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=46949100273&partnerID=8YFLogxK

U2 - 10.1007/s11060-008-9593-6

DO - 10.1007/s11060-008-9593-6

M3 - Article

C2 - 18398569

AN - SCOPUS:46949100273

VL - 89

SP - 97

EP - 103

JO - Journal of Neuro-Oncology

JF - Journal of Neuro-Oncology

SN - 0167-594X

IS - 1

ER -