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Adapted from the NCI Cancer Bulletin, vol. 4/no. 15, April 17, 2007 (see the current issue ³).

Elderly patients with glioblastoma benefit from palliative radiation therapy, which provides significantly increased survival with no detriment to quality of life, according to a study published in the April 12, 2007, New England Journal of Medicine (see the journal abstract). The randomized trial, conducted by the Association of French-Speaking Neuro-Oncologists, also highlighted the feasibility of enrolling elderly patients in cancer clinical trials.

The investigators enrolled 81 patients 70 years of age or older with glioblastoma into the trial (see the protocol summary ⁴). All patients had good functional status. Forty-two received supportive care alone, including antiseizure medication, physical and psychological support, and access to a palliative care team. The other 39 patients received supportive care and radiation therapy (50 Gy in doses of 1.8 Gy per day, given 5 days a week).

Patients receiving radiation therapy had a median survival of 29.1 weeks compared with 16.9 weeks for those receiving supportive care alone. Radiation therapy produced a survival benefit regardless of the extent of surgery performed, which ranged from biopsy alone to complete resection. Physical and mental status declined over time in both groups, with no significant differences observed between the groups. Perceived quality of life also did not differ between the groups.

The authors stated that "radiotherapy increases the median survival of elderly patients with glioblastoma who have a good performance status at the start of treatment." They also noted that "the optimal dose of radiotherapy in elderly patients remains undetermined." Other studies have indicated that various other palliative radiation regimens, using different doses and fractionation schemes, may provide similar benefit.

Glossary Terms

Care given to improve the quality of life of patients who have a serious or life-threatening disease. The goal of palliative care is to prevent or treat as early as possible the symptoms of a disease, side effects caused by treatment of a disease, and psychological, social, and spiritual problems related to a disease or its treatment. Also called comfort care, supportive care, and symptom management.

A study in which the participants are assigned by chance to separate groups that compare different treatments; neither the researchers nor the participants can choose which group. Using chance to assign people to groups means that the groups will be similar and that the treatments they receive can be compared objectively. At the time of the trial, it is not known which treatment is best. It is the patient's choice to be in a randomized trial.

Describes a mathematical measure of difference between groups. The difference is said to be statistically significant if it is greater than what might be expected to happen by chance alone. Also called significant.

Care given to improve the quality of life of patients who have a serious or life-threatening disease. The goal of supportive care is to prevent or treat as early as possible the symptoms of a disease, side effects caused by treatment of a disease, and psychological, social, and spiritual problems related to a disease or its treatment. Also called comfort care, palliative care, and symptom management.