Pretreatment Geriatric Assessments of Elderly Patients with Glioma: Development and Implications
Wang Yaning, Zhao Binghao, Chen Wanqi, Liu Lei, Chen Wenlin, Zhou Lizhou, Kong Ziren, Dai Congxin, Wang Yu, Ma Wenbin
Table 1 Characteristics of Clinical Trials Relating to Treatments (Surgery, Radiotherapy, Chemotherapy and chemoradiotherapy) for Glioma.
First author/published yearPatients’ characteristics (mean age, M/F)Intervention (number)Comparison (number)ResultsFollow-upStudy design
Surgery
Gupta et al/2018 [3]6.3 (3.3-17.5), 23/27biopsyNAIn 50 patients with DIPG going biopsy, 46 successfully captured tissue samplesFollowed until deathSingle-arm clinical trial
Kellermann et al/2017 [4]74 (70-87), 129/101stereotactic biopsyNATwo hundred and thirty nine of 230 elderly glioma patients received stereotactic biopsy, 222 achieved histopathologic diagnosis, and 171 received further adjuvant therapy1 yearRetrospective study
Tanaka et al/
2013 [5]
74.1 (66-87), 61/44stereotactic biopsy (52)surgery (53)Complications of postoperative bleeding is higher in patients undergoing stereotactic biopsy than in lesion removal surgery5 yearRetrospective study
Ostrom et al/
2018[18]
NA (59-64), 56/44NANAIncidence of glioma and 1-year and 5-year survival rates vary significantly by race and ethnicity with non-Hispanic whites having higher incidence and lower survival rate.14 yearRetrospective study
Radiotherapy
Keime et al/2007[40]73 (70-85), 51/30radiotherapy plus supportive care (39)supportive care (42)Radiotherapy brings better outcome than supportive care in geriatric GBM patients4 yearRCT
Douw et al/
2009[41]
44.2, 35/30NANASide effect of cognitive loss could only be found in low-grade young glioma patients with RT hindering our decision making12 yearProspective clinical study
Malmstrom et al/2012[42]no less than 60, 118/80hypofractionated RT (98)standard RT (100)OS in geriatric GBM patients receiving hypofractionated RT is comparable in those with standard radiotherapy9 yearRCT
Roa et al/2004 [43]elder than 60, 55/40standard RT (48)short-course RT (47)OS in geriatric GBM patients receiving hypofractionated RT is comparable in those with common radiotherapy5 yearRCT
Roa et al/2015 [44]no less than 50, 46/52short-course RT (50)standard RT (48)Hypofractionated radiotherapy regimens did not reveal different OS3 yearRCT
Bent et al/2005[45]38.8, 191/115early RT (after surgery) (154)deferred RT (152)Early radiotherapy after surgery lengthened PFS but not progression-free survival (PFS)7.8 yearRCT
Chemotherapy and chemoradiotherapy
Malmstrom et al/2012 [42]no less than 60, 173/118TMZ and hypofractionated RT (191)standard RT (100)Two weeks of massive fractionation RT or single TMZ could benefit geriatric GBM patients compared to six-week RT regimen9 yearRCT
Stupp et al/2009[56]360/213RT with concomitant adjuvant TMZ (287)RT (286)Six cycles of TMZ adjuvant chemoradiotherapy prolongs the survival of elderly patients with GBM2 yearRCT
Perry JR et al/2017[57]73 (65- 90), 43/219Short course RT (40Gy/15F) with concomitant adjuvant TMZ (281)Short course RT (281)The addition of temozolomide to short-course radiotherapy resulted in longer survival than short-course radiotherapy aloneAlmost all followed until deathRCT