OBJECTIVES: The optimal treatment for elderly patients (age >70 years) with 
glioblastoma (GBM) remains controversial. We conducted a prospective trial in 43 
consecutive elderly patients with GBM treated with hypofractionated radiotherapy 
(RT) followed by adjuvant temozolomide.
PATIENTS AND METHODS: Forty-three patients 70 years of age or older with a newly 
diagnosed GBM and a Karnofsky performance status (KPS) > or = 60 were treated 
with hypofractionated RT (6 fractions of 5 Gy each for a total of 30 Gy over 2 
weeks) followed by up to 12 cycles of adjuvant temozolomide (150-200 mg/m(2) for 
5 days during each 28 day cycle). The HRQOL was assessed with the EORTC Quality 
of Life Questionnaire C30. The primary endpoint was overall survival (OS). 
Secondary endpoints included progression free survival (PFS), toxicity and 
quality of life.
RESULTS: The median OS was 9.3 months and the median PFS was 6.3 months. The 6 
and 12 month survival rates were 86% and 35%, respectively. The 6 and 12 month 
PFS rates were 55% and 12%, respectively. In multivariate analysis KPS was the 
only significant independent predictive factor of survival (P = 0.008). 
Neurological deterioration occurred during or after RT in 16% of patients and 
was resolved in most cases with the use of steroids. Grade 3-4 hematologic 
toxicity occurred in 28% of patients during the adjuvant chemotherapy treatment 
with temozolomide. The treatment had no negative effect on HRQOL, however, 
fatigue (P = 0.02) and constipation (P = 0.01) scales worsened over time.
CONCLUSIONS: Hypofractionated RT followed by temozolomide may provide survival 
benefit maintaining a good quality of life in elderly patients with GBM. It may 
represent a reasonable therapeutic approach especially in patients with less 
favourably prognostic factors.