Treatment Patterns and Outcomes Among Elderly Glioblastoma Patients in Riyadh, Saudi Arabia

Amal Marie; Ahmed Maklad; Abdullah AlTwairgi; Moemen Aly; Ashraf Elyamany; Wafaa AlShaqweer; Mohamed Senosy; Ali Balbaid

doi:10.2147/OTT.S344700

Treatment Patterns and Outcomes Among Elderly Glioblastoma Patients in Riyadh, Saudi Arabia

Onco Targets Ther. 2022 Feb 2:15:135-144. doi: 10.2147/OTT.S344700. eCollection 2022.

Authors

Amal Marie^{1

2}, Ahmed Maklad^{1

3}, Abdullah AlTwairgi⁴, Moemen Aly^{1

5}, Ashraf Elyamany⁶, Wafaa AlShaqweer⁷, Mohamed Senosy¹, Ali Balbaid¹

Affiliations

¹ Department of Radiation Oncology, Comprehensive Cancer Centre, King Fahad Medical City, Riyadh, Saudi Arabia.
² Clinical Oncology Department, Ain Shams University, Cairo, Egypt.
³ Clinical Oncology Department, Sohag University, Sohag, Egypt.
⁴ Department of Medical Oncology, King Fahad Medical City, Riyadh, Saudi Arabia.
⁵ Department of Radiotherapy and Nuclear Medicine, South Egypt Cancer Institute, Assiut University, Assiut, Egypt.
⁶ Medical Oncology Department, SECI, Assiut University, Egypt/KSMC, Riyadh, Saudi Arabia.
⁷ Pathology Department, King Fahad Medical City, Riyadh, Saudi Arabia.

Abstract

Background: Management of elderly patients with glioblastoma (GBM) is a controversial scenario and needs careful assessment and selection for aggressive radical treatment and chemotherapy protocols vs short-course radiotherapy without chemotherapy.

Methods: We evaluated treatment patterns and outcome among elderly GBM patients treated in KFMC, Riyadh. The primary endpoint is overall survival (OS) and the secondary endpoint is progression-free survival (PFS); patients were reviewed regarding radiotherapy (Rth) fractionation modalities, surgery, and chemotherapy (CTR) given in correlation to PFS, OS.

Results: Fifty-nine patients were recruited in our study with median age 66 (range: 60-81) years, and 47 (80%) were males. Thirty-seven patients (62.7%) had ECOG performance status (PS) ≥2, and 22 patients (37.3%) had PS <2. Gross total resection (GTR) and subtotal resection (STR) were done in 49 (82.9%) patients, and the median follow-up was 12 months. Thirty-eight (64%) patients received conventional Rth 60 Gray (Gy)/30 fractions or equal doses and 21 (36%) patients received hypofractionation Rth (40 Gy/15, 25 Gy/5 or 30 Gy/10 fractions). The median OS was 12 months (95%CI: 9.52-14.48). Receiving conventional Rth and completion of six months adjuvant CTR were significant factors for O.S (P=0.043 and 0.026), respectively. The median PFS was nine months (95%CI: 6.13-11.87). For univariate analysis, PS, time to start adjuvant treatment, and completion of six months CTR were significant factors for PFS.

Conclusion: Conventional Rth and completion of adjuvant CTR lead to better OS, while earlier start of adjuvant treatment and the completion of adjuvant CTR were associated with a better PFS.

Keywords: chemotherapy; elderly; glioblastoma; radiotherapy.