Abstract Details

Title Geriatric Syndromes and Treatment Toxicities in Older Patients with Malignant Gliomas

Topic Neuro-oncology

Presentation(s) P3 - Poster Session 3 (12:00 PM-1:00 PM)

Poster/Presentation
Number 13-003

Objective To describe treatment toxicities and geriatric syndromes in older patients with malignant gliomas (MG).

Background Advanced age in cancer patients is associated with increased treatment-related toxicities, acute care utilization and functional decline. Most MG patients are over age 65, yet treatment patterns, toxicities and outcomes are not well defined.

Design/Methods IRB approved retrospective chart review of 125 MG patients age 65 or older at the University of Rochester Medical Center from January 2012 to December 2018.

Results 115 glioblastoma and 10 anaplastic astrocytoma patients with a median age of 71 (range 65-89) at diagnosis had a median overall survival (OS) of 10.3 months. Radiotherapy (RT) was offered and completed in 84% (fractionated, n=75, hypofractionated, n=12). RT was not completed in 8% of patients receiving fractionated RT. 25% of the 97 patients treated with concurrent temozolomide (TMZ) experienced treatment delays (n=24). A median of 4 cycles of adjuvant TMZ were taken by 61% (n=76) of patients. Delays and dose reductions occurred in 50% during treatment with adjuvant TMZ, most commonly due to thrombocytopenia (n=15) and fatigue (n=15). 16/97 patients required transfusions during treatment with concurrent or adjuvant TMZ. At baseline, patients were prescribed a median of 11 medications. OS was longer in patients prescribed less than 8 medications vs. 8 or more (14 vs. 8.6 months, p= 0.0738). Additional medications added during treatment included corticosteroids (n=125), chemotherapy (n=97), antiemetics (n=100), proton pump inhibitors (n=125), antidepressants (n=69). 65% experienced a non-elective hospital visit and 64% reported at least one fall.

Conclusions Older patients with MG experience significant polypharmacy, cancer therapy toxicities and iatrogenic events that may be underreported. Studies incorporating geriatric assessment tools may be able to better determine associations between geriatric syndromes and survival. Clinical trials in older patients should better delineate non-survival outcomes to understand whether interventions lead to more benefit or harm.

Authors/Disclosures
Ahmar Alam PRESENTER	No disclosure on file
Andrea C. Wasilewski, MD (Givens Brain Tumor Center)	Dr. Wasilewski has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novocure. Dr. Wasilewski has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Servier Pharmaceuticals .
Nimish A. Mohile, MD, FAAN	The institution of Dr. Mohile has received research support from Novocure.

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