Patterns of care and outcomes in elderly patients with glioblastoma in Sao Paulo, Brazil: A retrospective study

Objective: To analyze how elderly patients with glioblastoma are managed in Brazil. Material and Methods: We identified 30 patients aged >= 65 years treated between 2003 and 2011 at Albert Einstein Hospital in Sao Paulo. We retrospectively reviewed medical records to obtain data on clinical variables, treatment and outcomes. Overall survival (OS) was evaluated using Kaplan-Meier methods and compared using a Wilcoxon log-rank test. Results: The median age was 73 years. The majority of patients (73.2%) underwent surgical intervention. Following surgery, 80% received radiotherapy (RT), and of those, 79.2% were treated with concurrent temozolomide (TMZ). The median progression free survival and OS were 5 and 10.6 months, respectively. Patients with a KPS >= 70 had a median OS of 16.2 months, compared to 6.4 months for those with a KPS <70 (p = 0.032). For those patients in whom biopsy only was performed, the median OS was 5.3 months, as compared to 7.8 months for those who underwent partial resection and 18.6 months for those treated with gross total resection (p = 0.021). A longer survival was found among patients who received RT versus those who did not (11 months vs. 1 month, p = 0.003), as well as for those treated with chemoradiation (13.6 months vs. 6.4 months, p < 0.0001). Conclusions: This study brings new information about the management of elderly patients with glioblastoma in Brazil. Our data may suggest that elderly patients who undergo cytoreductive surgery and adjuvant RT with concurrent TMZ can do better than those with less aggressive treatment. (C) 2013 Elsevier Ltd. All rights reserved.