Liu Y, et al. – For elderly patients with glioblastoma and impaired performance status, experts investigated the effects of temozolomide (TMZ) versus best supportive care (BSC) in this population. TMZ increased survival with acceptable toxicity in these individuals, as compared to BSC.

Methods

• A retrospective observational study of patients aged ≥65 years with histologically confirmed GBM and KPS scores ≤70 who were treated at the institution between January 2006 and July 2014, was performed.
• Examination was done for demographic data, treatments, and outcomes .
• In order to determine the independent prognostic factors of overall survival (OS) and progression-free survival (PFS), univariate and multivariate analyses were performed.
• Propensity score matching of clinicopathological factors was applied to assess the impact of TMZ on survival among patients who received TMZ vs BSC.

Results

• This study incorporated 153 patients (86 men, 56.2%).
• As per observations, the median patient age was 70 years (range: 65–83 years).
• 60 (range: 30–70) was the median KPS score.
• Furthermore, seventy-eight patients (51.0%) received TMZ.
• On the other hand, BSC was given to 75 (49.0%).
• 6.0 and 4.5 months were median OS and PFS.
• Results revealed an association of TMZ with improved OS (hazard ratio [HR]: 0.38, 95% CI: 0.17–0.70; P=0.002) and PFS (HR: 0.41, 95% CI: 0.21–0.76; P=0.003) after propensity score matching than BSC.
• KPS score (HR: 2.11, 95% CI: 1.48–7.67; P=0.016), extent of resection (HR: 1.98, 95% CI: 1.45–5.14; P=0.026), and treatment group (HR: 0.49, 95% CI: 0.23–0.87; P=0.019) were determined as factors independently associated with OS.
• Myelosuppression was found to be the most frequent toxicity in the TMZ group.