Survival outcomes in elderly/poor PS patients with glioblastoma
Research type
Research Study
Full title
The role of combined modality therapy in management of elderly and poor performance status patients with Glioblastoma and correlation with molecular phenotypes.
IRAS ID
202948
Contact name
Mohan Hingorani
Contact email
Sponsor organisation
Hull and east Yorkshire NHS Trust
Duration of Study in the UK
0 years, 3 months, 5 days
Research summary
Glioblastoma is the most common malignant primary brain tumor and prognosis remains poor with an average life expectancy of 12-14 months. The standard treatment protocol includes surgical debulking followed by concurrent chemoradiotherapy (6 weeks) with Temozolomide (TMZ) and further six cycles of adjuvant Temozolomide. Patients more than 70 years of age and those with poor performance status (PS) have particularly poor prognosis and do not benefit from long-course chemoradiotherapy due to poor tolerance and associated side-effects.
There is little evidence on optimum management of this group of patients. Previous randomised studies have evaluated role of single modality treatment including radiotherapy or chemotherapy alone (TMZ) in patients demonstrating methylation of methyl-guanine methyl transferase (MGMT) promoter that predicts sensitivity to TMZ chemotherapy. these studies have demonstrated equivalent outcomes for above modalities. However, there is little evidence on use of combined-modality therapy in this group of patients.
In our centre, these patients are treated with short-course hypo-fractionated radiotherapy. Patients who are fit and well after initial radiotherapy are treated with six cycles of adjuvant Temozolomide with appropriate dose-modification. In our experience, the combined modality regime is well-tolerated with no significant side-effects and proportion of patients demonstrate prolonged survival with good quality of life which appears to be superior to historical controls. The present study aims to retrospectively evaluate the tolerance and associated toxicities and survival outcomes of patients treated within above treatment protocols. In addition, the study will aim to assess the relationship between survival and MGMT expression to demonstrate any co-relation and patterns of association between above parameters. The data generated from above study will provide useful evidence on management of a fragile sub-group of patients with glioblastoma.REC name
North East - York Research Ethics Committee
REC reference
16/NE/0226
Date of REC Opinion
4 Jul 2016
REC opinion
Favourable Opinion