Radiation for 70 yr old (glioblastomas grade 4)?

Posted by antoines @antoines, Jan 20, 2024

Good afternoon,
A friend of mine learned that her dad was diagnosed with glioblastomas (grade 4.) He is 70 years old. He did the surgery and the surgeon asked the family whether to proceed with the chemo and radiation.
At this moment, he can barely walk.
The radiation will be around 8 weeks and we were wondering what would be the benefit of it. Reading articles, it seems that for his age, the gain would be marginal and if it is to gain 3 months more but 2 of them (at the start) are lost in daily radiation at the hospital, is it worth it?
Also, we were wondering as one of the potential benefit would be an health improvement (after some potential difficult moment during the chemo) but we could not find whether or not it would be the case?
Finally, is there any benefit in doing only chemo (which consist in daily pills but can be done at home hence less demanding)?
Did anyone had this dilemma and what was their choice/guidance? Any (recent) article/research paper?
For me it seems the most important question instead of increasing the life expectancy, is the state he will be in during/after the treatment.

Thanks for reading and any help would be more than welcome in this difficult moment

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ruthannray | @ruthannray | Jan 21, 2024

Why is the surgeon asking this question? There should be a neuro oncologist involved plus a radiation oncologist, both giving advice and statistics. I believe there are studies for 70 year olds that are useful.

Eight weeks of radiation is a LOT. My understanding is that 30 treatments (6 weeks) is the standard of care if you are below the age cut off (My 86 year old husband has grade 4 Glioblastoma, had surgical biopsy only because inoperable due to location of tumor. He had 10 radiation treatments plus the temodar chemotherapy is ongoing. It’s tough, but his tumor has responded well. As for quality of life, it’s hard to say. We went to church and lunch today, which was great. But his cognition has been impacted, which might have been underway anyway. )

We were told some patients get the radiation and 1 course of chemotherapy and call it a day.

Was the Optune device recommended? It’s a tumor treating field device, approved by Medicare for Glioblastoma only. My husband couldn’t deal with it because it agitated him, it didn’t hurt. Just a lot of work to wear the device. Electrode arrays, cords, a battery pack. But for younger folks this device makes sense.

Sorry I can’t cite studies. I’d push the doctors for more information and/or ask for study citations.