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

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.

Data di pubblicazione: 2016
Titolo: Which elderly newly diagnosed glioblastoma patients can benefit from radiotherapy and temozolomide? A PERNO prospective study
Autori: Franceschi, E.; Depenni, R.; Paccapelo, Alexandro; Ermani, Mario; Faedi, M.; Sturiale, Carmelo; Michiara, Maria; Servadei, F.; Pavesi, Giacomo; Urbini, B.; Pisanello, A.; Crisi, G.; Cavallo, Michele A.; Dazzi, C.; Biasini, C.; Bertolini, F.; Mucciarini, C.; Pasini, G.; Baruzzi, Agostino; Brandes, Alba A; Albani, F.; Calbucci, F.; D’alessandro, R.; Michelucci, R.; de Pasqua, S.; Testoni, S.; Brandes, A.; Tosoni, A.; Eusebi, V.; Ceruti, Stefano; Fainardi, Enrico; Tamarozzi, R.; Emiliani, E.; Cavallo, Michele Alessandro; Fiorica, F.; Sasso, E.; Cavanna, L.; Guidetti, D.; Marcello, N.; Cremonini, A. M.; Guiducci, G.; Agati, R.; Ambrosetto, G.; Bacci, A.; Baldin, E.; Baldrati, A.; Barbieri, E.; Bartolini, S.; Bellavista, E.; Bisulli, F.; Bonora, E.; Bunkheila, F.; Carelli, V.; Crisci, M.; Dall’occa, P.; de Biase, D.; Ferro, S.; Franceschi, C.; Frezza, G.; Grasso, V.; Leonardi, M.; Marucci, G.; Morandi, L.; Mostacci, B.; Palandri, G.; Pasini, E.; Pastore Trossello, M.; Pession, A.; Poggi, R.; Riguzzi, P.; Rinaldi, R.; Rizzi, S.; Romeo, G.; Spagnolli, F.; Tinuper, P.; Trocino, C.; Dall’agata, M.; Frattarelli, M.; Gentili, G.; Giovannini, A.; Iorio, P.; Pasquini, U.; Galletti, G.; Guidi, C.; Neri, W.; Patuelli, A.; Strumia, S.; Casmiro, M.; Gamboni, A.; Rasi, F.; Cruciani, G.; Cenni, P.; Guidi, A. R.; Zumaglini, F.; Amadori, A.; Pasquinelli, M.; Pasquini, E.; Polselli, A.; Ravasio, A.; Viti, B.; Sintini, M.; Ariatti, A.; Bigliardi, G.; Carpeggiani, P.; Cavalleri, F.; Meletti, S.; Nichelli, P.; Pettorelli, E.; Pinna, G.; Zunarelli, E.; Artioli, F.; Bernardini, I.; Costa, M.; Greco, G.; Guerzoni, R.; Stucchi, C.; Iaccarino, C.; Ragazzi, M.; Rizzi, R.; Zuccoli, G.; Api, P.; Cartei, F.; Colella, M.; Fallica, Elisa; Farneti, Marco; Frassoldati, Antonio; Granieri, Enrico Gavino Giuseppe; Latini, Francesco; Monetti, C.; Saletti, Andrea; Schivalocchi, Roberta; Sarubbo, Silvio; Seraceni, S.; Tola, Maria Rosaria; Zini, G.; Giorgi, C.; Montanari, E.; Cerasti, D.; Crafa, P.; Dascola, I.; Florindo, I.; Giombelli, E.; Mazza, S.; Ramponi, Vania; Silini, E. M.; Torelli, P.; Immovilli, P.; Morelli, N.; Vanzo, C.; Nobile, C.
Rivista: JOURNAL OF NEURO-ONCOLOGY
Parole Chiave: Elderly; Glioblastoma; MGMT methylation; Radiotherapy; Temozolomide; Oncology; Neurology; Neurology (clinical); Cancer Research
Abstract in inglese: 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.
Digital Object Identifier (DOI): 10.1007/s11060-016-2093-1
Handle: http://hdl.handle.net/11392/2373631
Appare nelle tipologie:03.1 Articolo su rivista

File in questo prodotto:
Non ci sono file associati a questo prodotto.
Utilizza questo identificativo per citare o creare un link a questo documento:
http://hdl.handle.net/11392/2373631
  • Citazioni
  • PubMed Central
  • Scopus
  • WOS
I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
 
 
 
Powered by IRIS-about IRIS-Utilizzo dei cookie
Logo CINECA  Copyright © 2022