When less is better: care of the elderly with glioblastoma

The recent publication in the New England Journal of Medicine of a randomized trial in elderly patients with newly diagnosed glioblastoma conducted and supported by the Canadian Cancer Trials Group, the European Organisation for Research and Treatment of Cancer, and the Trans Tasman Radiation Oncology Group provides continued practical advances for patient care.¹ The study, led by Dr James Perry, addressed the role of adjuvant and maintenance temozolomide in the elderly (defined as 65 years of age or older). The report convincingly provides support for the use of chemotherapy, particularly in those with methylated O⁶-methyl-guanine-DNA methyltransferase (MGMT)¹—a logical and needed extension from previous studies that have demonstrated a role for shorter course radiation therapy in the elderly as well as temozolomide chemotherapy alone in elderly patients with methylated MGMT.² The trial was well designed and performed randomizing 562 patients between November 2007 and September 2013 between arms of radiotherapy to a total dose of 40.05 Gy in 15 daily fractions over 3 weeks either alone or with temozolomide at 75 mg/m² per day for the same 21-day interval. MGMT status was determined on 354 samples. The arms were well balanced with an important median age of 73 years, with 29.5% older than 75.

from # All Medicine by Alexandros G. Sfakianakis via ola Kala on Inoreader http://ift.tt/2sC6cVG
via IFTTT