ArticleJournal of neuro-oncology2017
Recurrent glioblastomas in the elderly after maximal first-line treatment: does preserved overall condition warrant a maximal second-line treatment?
Article in Journal of neuro-oncology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 5 of them syntheses that pooled it.
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Who cites it
18 citing papers in PubMed, 5 syntheses or guidelines pooled it, 40 citations in OpenAlex.
- Surgical treatment of recurrent glioblastoma: a multicenter perspective from the Italian society of neurosurgery (SINchNeurosurgical review · 2026Pooled it
- Surgical management of Glioma Grade 4: technical update from the neuro-oncology section of the Italian Society of Neurosurgery (SINch®): a systematic review.Journal of neuro-oncology · 2023Pooled it
- Assessing the efficacy of repeat resections in recurrent glioblastoma: a systematic review.Neurosurgical review · 2021Pooled it
- Carmustine as a Supplementary Therapeutic Option for Glioblastoma: A Systematic Review and Meta-Analysis.Frontiers in neurology · 2020Pooled it
- A Meta-Analysis of Survival Outcomes Following Reoperation in Recurrent Glioblastoma: Time to Consider the Timing of Reoperation.Frontiers in neurology · 2019Pooled it
- Management of glioblastoma in the elderly.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Article
- Management of glioblastoma in elderly patients: A review of the literature.Clinical and translational radiation oncology · 2024Review
- Treatment Outcomes after Dose-Escalated Moderately Hypofractionated Radiotherapy for Frail Patients with High-Grade Glioma.Cancers · 2023Article
- Article
- Recurrent glioblastoma in elderly: Options and decision for the treatment.Surgical neurology international · 2022Review
- Impacts of genotypic variants on survival following reoperation for recurrent glioblastoma.Journal of neuro-oncology · 2022Article
- Re-irradiation for high-grade gliomas: Has anything changed?World journal of clinical oncology · 2021Review
- Article
- ＜Editors' Choice＞ Impact of maintenance of postoperative performance status on survival in elderly patients over 70 with high-grade astrocytoma.Nagoya journal of medical science · 2020Article
- Guiding Treatment Choices for Elderly Patients with Glioblastoma by a Comprehensive Geriatric Assessment.Current oncology reports · 2020Review
- Biweekly fotemustine schedule for recurrent glioblastoma in the elderly: activity and toxicity assessment of a multicenter study.CNS oncology · 2019Article
- Survival in elderly glioblastoma patients treated with bevacizumab-based regimens in the United States.Neuro-oncology practice · 2018Article
- One decade of glioblastoma multiforme surgery in 342 elderly patients: what have we learned?Journal of neuro-oncology · 2018Article
Corrections and comments
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Authors and funding
26 authors at 14 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
A growing literature supports maximal safe resection followed by standard combined chemoradiotherapy (i.e. maximal first-line therapy) for selected elderly glioblastoma patients. To assess the prognostic factors from recurrence in elderly glioblastoma patients treated by maximal safe resection followed by standard combined chemoradiotherapy as first-line therapy. Multicentric retrospective analysis comparing the prognosis and optimal oncological management of recurrent glioblastomas between 660 adult patients aged of < 70 years (standard group) and 117 patients aged of ≥70 years (elderly group) harboring a supratentorial glioblastoma treated by maximal first-line therapy. From recurrence, both groups did not significantly differ regarding Karnofsky performance status (KPS) (p = 0.482). Oncological treatments from recurrence significantly differed: patients of the elderly group received less frequently oncological treatment from recurrence (p < 0.001), including surgical resection (p < 0.001), Bevacizumab therapy (p < 0.001), and second line chemotherapy other than Temozolomide (p < 0.001). In multivariate analysis, Age ≥70 years was not an independent predictor of overall survival from recurrence (p = 0.602), RTOG-RPA classes 5-6 (p = 0.050) and KPS at recurrence <70 (p < 0.001), available in all cases, were independent significant predictors of shorter overall survival from recurrence. Initial removal of ≥ 90% of enhancing tumor (p = 0.004), initial completion of the standard combined chemoradiotherapy (p = 0.007), oncological treatment from recurrence (p < 0.001), and particularly surgical resection (p < 0.001), Temozolomide (p = 0.046), and Bevacizumab therapy (p = 0.041) were all significant independent predictors of longer overall survival from recurrence. Elderly patients had substandard care from recurrence whereas age did not impact overall survival from recurrence contrary to KPS at recurrence <70. Treatment options from recurrence should include repeat surgery, second line chemotherapy and anti-angiogenic agents.
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