Geriatric assessment of glioblastoma patients is feasible and may provide useful prognostic information.
elderly
geriatric assessment
glioblastoma
Journal
Neuro-oncology practice
ISSN: 2054-2577
Titre abrégé: Neurooncol Pract
Pays: England
ID NLM: 101640528
Informations de publication
Date de publication:
Mar 2020
Mar 2020
Historique:
entrez:
7
7
2020
pubmed:
7
7
2020
medline:
7
7
2020
Statut:
ppublish
Résumé
Glioblastoma (GBM) is the most common and most lethal primary brain tumor in adults. Clinical trials in older patients with GBM have explored the use of single and multimodality treatment regimens with modest survival benefits; however, trial criteria are commonly based on chronological age and do not reflect the heterogeneity of this cohort. Geriatric assessment (GA) techniques predict survival and treatment tolerance in other tumor sites and thus may objectively guide the decision-making process, but data are lacking in the neuro-oncology cohort. We performed a prospective, multicenter feasibility study involving patients age 65 years or older with newly diagnosed GBM. A modified GA was undertaken in the outpatient setting prior to starting treatment. Feasibility was determined primarily by recruitment rate, alongside data completeness, impact on clinic time, and acceptability to patients and staff. Factors associated with survival were explored using Cox regression models. Fifty patients were recruited within a prespecified time period with a recruitment rate of 82% (target 80%). Data completeness was greater than 80% in all except one assessment. Median overall survival was 9.5 months (95% confidence interval [CI] 5.0-14.0 months). Among the GA screening factors analyzed, a baseline impaired Montreal Cognitive Assessment (hazard ratio [HR] = 2.7, 95% CI 1.128-6.530) and impairment in instrumental activities of daily living (HR = 2.9 95% CI 0.983-8.541) were associated with poorer survival. In the first study of this kind among elderly GBM patients, we have shown that undertaking a neurologically focused GA screen is feasible and may provide useful prognostic information.
Sections du résumé
BACKGROUND
BACKGROUND
Glioblastoma (GBM) is the most common and most lethal primary brain tumor in adults. Clinical trials in older patients with GBM have explored the use of single and multimodality treatment regimens with modest survival benefits; however, trial criteria are commonly based on chronological age and do not reflect the heterogeneity of this cohort. Geriatric assessment (GA) techniques predict survival and treatment tolerance in other tumor sites and thus may objectively guide the decision-making process, but data are lacking in the neuro-oncology cohort.
METHODS
METHODS
We performed a prospective, multicenter feasibility study involving patients age 65 years or older with newly diagnosed GBM. A modified GA was undertaken in the outpatient setting prior to starting treatment. Feasibility was determined primarily by recruitment rate, alongside data completeness, impact on clinic time, and acceptability to patients and staff. Factors associated with survival were explored using Cox regression models.
RESULTS
RESULTS
Fifty patients were recruited within a prespecified time period with a recruitment rate of 82% (target 80%). Data completeness was greater than 80% in all except one assessment. Median overall survival was 9.5 months (95% confidence interval [CI] 5.0-14.0 months). Among the GA screening factors analyzed, a baseline impaired Montreal Cognitive Assessment (hazard ratio [HR] = 2.7, 95% CI 1.128-6.530) and impairment in instrumental activities of daily living (HR = 2.9 95% CI 0.983-8.541) were associated with poorer survival.
CONCLUSION
CONCLUSIONS
In the first study of this kind among elderly GBM patients, we have shown that undertaking a neurologically focused GA screen is feasible and may provide useful prognostic information.
Identifiants
pubmed: 32626586
doi: 10.1093/nop/npz040
pii: npz040
pmc: PMC7318852
doi:
Types de publication
Journal Article
Langues
eng
Pagination
176-184Informations de copyright
© The Author(s) 2019. Published by Oxford University Press on behalf of the Society for Neuro-Oncology and the European Association of Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
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