Palliative Radiation Extends Survival for Elderly Patients with Glioblastoma
Adapted from the NCI Cancer Bulletin.
Elderly patients with glioblastoma benefit from palliative radiation therapy, which provides significantly increased survival with no detriment to quality of life, according to a study published in the April 12, 2007, New England Journal of Medicine (see the journal abstract). The randomized trial, conducted by the Association of French-Speaking Neuro-Oncologists, also highlighted the feasibility of enrolling elderly patients in cancer clinical trials.
The investigators enrolled 81 patients 70 years of age or older with glioblastoma into the trial (see the protocol summary). All patients had good functional status. Forty-two received supportive care alone, including antiseizure medication, physical and psychological support, and access to a palliative care team. The other 39 patients received supportive care and radiation therapy (50 Gy in doses of 1.8 Gy per day, given 5 days a week).
Patients receiving radiation therapy had a median survival of 29.1 weeks compared with 16.9 weeks for those receiving supportive care alone. Radiation therapy produced a survival benefit regardless of the extent of surgery performed, which ranged from biopsy alone to complete resection. Physical and mental status declined over time in both groups, with no significant differences observed between the groups. Perceived quality of life also did not differ between the groups.
The authors stated that "radiotherapy increases the median survival of elderly patients with glioblastoma who have a good performance status at the start of treatment." They also noted that "the optimal dose of radiotherapy in elderly patients remains undetermined." Other studies have indicated that various other palliative radiation regimens, using different doses and fractionation schemes, may provide similar benefit.
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