No Difference in Outcomes With Short-Course vs Longer-Course Radiotherapy in Elderly or Frail Patients With Newly Diagnosed Glioblastoma


Key Points

  • No difference in overall or progression-free survival was observed between short-course and longer-course radiotherapy in elderly or frail patients with  newly diagnosed glioblastoma.
  • No difference in quality of life was observed.

In a noninferiority phase III trial reported in the Journal of Clinical Oncology, Roa et al found no difference in overall survival, progression-free survival, or quality of life between short-course and longer-course radiotherapy in elderly or frail patients with newly diagnosed glioblastoma multiforme.

Study Details

In the trial, 98 patients from 12 sites worldwide were randomly assigned between 2010 and 2013 to receive short-course radiotherapy consisting of 25 Gy in five daily fractions over 1 week (n = 48) or a commonly used longer course of 40 Gy in 15 daily fractions over 3 weeks (n = 50). Patients had to be frail (aged ≥ 50 years with a Karnofsky performance status [KPS] of 50%–70%), elderly and frail (aged ≥ 65 years and a KPS of 50%–70%), or elderly (aged ≥ 65 years and a KPS of 80%–100%). The primary endpoint was overall survival.

No Differences in Outcomes

Median overall survival was 7.9 months (95% confidence interval [CI] = 6.3–9.6 months) in the short-course group vs 6.4 months (95% CI = 5.1–7.6 months) in the longer-course group (P = .988; noninferiority criterion satisfied). Median progression-free survival was 4.2 months (95% CI = 2.5–5.9 months) vs 4.2 months (95% CI = 2.6–5.7 months; P = .716).

There was no acute toxicity ≥ grade 3. There were no differences between the groups at 4 or 8 weeks after treatment in quality of life measured by the European Organization for Research and Treatment of Cancer (EORTC) Quality-of-Life Questionnaire C30 and EORTC Quality-of-Life Questionnaire Brain Cancer Module.

The investigators concluded: “There were no differences in overall survival time, progression-free survival time, and quality of life between patients receiving the two radiotherapy regimens. In view of the reduced treatment time, the short 1-week radiotherapy regimen may be recommended as a treatment option for elderly and/or frail patients with newly diagnosed glioblastoma.”

Wilson Roa, MD, of Cross Cancer Institute, University of Alberta, is the corresponding author of the Journal of Clinical Oncology article.

The study was supported by the International Atomic Energy Agency (IAEA) under the IAEA Coordinated Research Activities. For full disclosures of the study authors, visit

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