QOL-31. A single-center experience of elderly glioblastoma treatment – standard vs hypofractionated radiotherapy with concurrent temozolomide

Abstract BACKGROUND There is no standard treatment for patients over the age of 70 with glioblastoma. We set out to characterize our experience treating glioblastoma patients over 70 years with standard chemoradiotherapy compared to hypofractionated radiation with concurrent temozolomide as well as compared to patients younger than 70 years old who received standard chemoradiotherapy. METHODS We performed a retrospective review of patients over 70 years with glioblastoma between January 1, 2012 and December 31, 2024. We identified and randomly selected patients who received a standard radiation course 60 Gy (group 1) versus a hypofractionated (3-4 week) course of radiation (group 2). Then, we randomly selected a secondary control group of patients younger than 70 years old who received standard radiation (group 3). All patients included received concurrent chemotherapy (temozolomide) during radiation. RESULTS The median age was 72 years in group 1 and 76 years in group 2, and the percentage of male patients was 54.8% and 52.8%, respectively. Median KPS in both groups 1 and 2 was 80. Extent of resection was similar between groups 1 and 2 (p=0.938). Concurrent chemotherapy was discontinued or held in 38.7% in group 1, 16.7% in group 2, and 21.1% in group 3 (p=0.091, p=0.040 between groups 1 and 2). Between groups 1 and 2, admission rates during chemoradiotherapy were 22.6% and 13.9%, respectively (p=0.272). Overall survival (OS) for group 1 was 23.18 months compared to 19.65 months in group 2 (p=0.267). DISCUSSION Despite similar KPS and extent of resection, glioblastoma patients older than 70 years treated with standard chemoradiotherapy had higher rates of chemotherapy discontinuation and higher admission rates but similar (OS). Our experience suggests the need for careful multidisciplinary consideration in the selection of older patients to receive standard chemoradiotherapy.