Radiotherapy is effective in patients with glioblastoma multiforme with a limited prognosis and in patients above 70 years of age: A retrospective single institution analysis

Background and purpose: To evaluate the efficacy of radiotherapy in patients with glioblastoma multiforme (GBM) with a limited prognosis and in patients older than 70 years. Patients and methods: Retrospective analysis of 202 patients with GBM treated between 1990 and 2000 in a single institution. Patients (including patients ! 70 years) were assigned to RPA groups and their survival was compared with RTOG data. Results: Median survival was 8.0 months for the total group and 13.9, 10.6, 3.8, 2.1 months for RPA group III (n = 17), IV (n = 87), V (n = 60) and VI (n = 38), respectively. Median survival for patients ! 70 years was 3.6 vs. 8.1 months for 50-70 years and 11.0 months for < 50. In each separate RPA group, patients !:70 years had a similar survival compared to patients of 50-70 years. Irradiated patients (66%) survived significantly longer than non-irradiated patients: 10.6 vs. 1.9 months (P < 0.0001). In RPA group V the median survival for irradiated patients was 9.4 vs. 2.1 months for non-irradiated patients. In a multivariate analysis, RT remained the only prognostic factor for survival (HR 8.9, P < 0.001). Conclusions: Prognosis for patients above 70 years of age is not different from younger patients, when analyzed for separate RPA groups. For patients with a poor prognosis (i.e. RPA group V), radiotherapy improves survival significantly. (c) 2005 Elsevier Ireland Ltd. All rights reserved.