Details

Autor(en) / Beteiligte

• Lombardi, Giuseppe
• Bergo, Eleonora
• Bellu, Luisa
• Caccese, Mario
• Lettiero, Annunziata
• Tierno, Giuseppina
• Pambuku, Ardi
• Brunello, Antonella
• Zagonel, Vittorina

Titel

NCOG-12. COMPREHENSIVE GERIATRIC ASSESSMENT (CGA) FOR OUTCOME PREDICTION IN ELDERLY PATIENTS (PTS)WITH GLIOBLASTOMA (GBM): A MONO-INSTITUTIONAL EXPERIENCE

Ist Teil von

• Neuro-oncology (Charlottesville, Va.), 2018-11, Vol.20 (suppl_6), p.vi175-vi175

Ort / Verlag

US: Oxford University Press

Erscheinungsjahr

2018

Link zum Volltext

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• Abstract BACKGROUND Treatment for GBM elderly PTS is still a challenge in neuro-oncology. Clinical tools, including CGA, are needed for improving treatment decision and outcome. The aim of this study was to evaluate CGA as a prognostic tool in terms of PFS and OS in elderly GBM PTS. METHODS We performed a retrospective analysis of elderly PTS ≥ 65 years, treated at Veneto Institute of Oncology between January 2011 and January 2018, with newly histologically diagnosed GBM and receiving a baseline CGA after 3–4 weeks from surgery. CGA included the following domains: age, activities and instrumental activities of daily living (ADL, IADL), cognitive status (MMSE), mood (GDS), nutritional status (MNA), number of drugs, comorbidity (cumulative Illness Rating Scale-CIRS), presence of geriatric syndromes, presence of caregiver. PTS were classified according to Balducci’s criteria into Fit or Unfit (Frail and Vulnerable). RESULTS 113 PTS were enrolled: 72(64%) were male, KPS were ≥ 70 in 90 PTS(80%); 37 PTS(33%) had a radical surgery, 63% partial surgery and 4% received a biopsy. 90 PTS(80%) received Stupp treatment, 16 (14%) temozolomide or radiotherapy alone and, only 7(6%) received no treatment. MGMT methylation status was analyzed in 96 PTS: 44% were metMGMT. According to CGA evaluation: 40 PTS(35.4%) were classified as Fit and 73 PTS(64.6%) Unfit. PFS was 11.2(95% CI 6.0–16.4) and 7.2(95% CI 5.8–8.6) months for Fit and Unfit PTS (p=0.1). On multivariate analysis, adjusted for type of surgery, MGMT methylation status and type of therapy, PFS was significantly different between the two groups (HR=0.6, 95% CI 0.2–0.9; p=0.04). OS was 16.4(95% CI 14.6–18.2) and 10.6(95% CI 8.3–12.8) ms for Fit and Unfit PTS (p=0.04); on multivariate analysis the HR was 0.51(95% CI 0.2–0.9; p=0.04). CONCLUSIONS: CGA demonstrated significant outcome prediction in terms of OS and PFS, regardless of therapy and it could be a useful treatment decision-tool.