Abstract

Objective: Glioblastoma multiforme (GBM) is a significant health issue in older patients. In recent years, there has been an increase in the number of studies on radiotherapy and concomitant temozolomide administration. However, there is not enough research on the tolerance of adjuvant temozolomide after this intensive therapy procedure.

Materials and Methods: Patients with GBM who were followed up between 2010 and 2020 were included. Patients were retrospectively screened. Side effect grading of patients was performed using the common terminology criteria for adverse events version 5.0.

Results: In patients ≤65 years old, 79.1% (121) received adjuvant temozolomide treatment for six months or more, whereas this rate decreased to 48.4% (15) in patients >65 years old (p<0.001). In the comparison of hematological toxicities arising during adjuvant temozolomide treatment in the ≤65 years old and older patient groups, no significant differences were found. The rates of patients experiencing grade 2 and above hematologic toxicity (p=0.91) and treatment discontinuation due to hematologic toxicity (p=0.53) were found to be similar in both groups. The median progression-free survival (p=0.004) and the median overall survival were (p<0.001) determined longer in the younger group.

Conclusion: Cancer and aging are dynamic, multidimensional processes that pose challenges to older patients and require multidisciplinary evaluation. Our study showed that although age-related differences in treatment completion and survival outcomes were observed, it is necessary to approach especially older patients individually, considering a comprehensive assessment of their general health status, comorbidities, and treatment tolerance, emphasizing the importance of geriatric oncology.