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OBJECTIVES Few studies have investigated the frequency of adverse event (AE) by adjuvant therapy modalities in elderly patients with glioblastoma (GBM) in “real-world” setting. We conducted a retrospective cohort analysis to compare survival differences and incidences of AE with different treatment modalities. METHODS A total of 3100 elderly GBM patients were derived from the Surveillance, Epidemiology and End Results (SEER)-Medicare dataset (2004–2013). Adjuvant therapy modalities were either chemoradiation (CRT) followed by maintenance chemotherapy with temozolomide or RT alone. Primary outcomes include overall survival (OS) and cumulative incidences of 6-month and 1-year AEs with adjuvant therapies. Kaplan-Meier method and Cox proportional hazards regression were applied for survival analysis. Fine-Gray competing risk models were performed to estimate the risk of incident AEs over time with death as the competing risk event. RESULTS Superior OS was observed among GBM patients treated with CRT compared to RT alone (median OS: 6.9 vs. 2.9 months, P&lt; 0.001). In multivariable Cox proportional hazard model, the risk of death was decreased by 52% for patients in the CRT group over the RT alone group (P&lt; 0.001). Based on the multivariable competing risk models, the receipt of CRT was associated with higher risk of incident 6-month AEs with nausea/vomiting [sub-hazard ratio (SHR): 1.82, P=0.003] and constipation (SHR: 1.47, P=0.022); and 1-year AEs with neutropenia (SHR: 1.63, P=0.002), anemia (SHR: 1.64, P&lt; 0.002), DVT (SHR: 1.25, P=0.035), seizure/epilepsy (SHR: 1.47, P=0.001), nausea/vomiting (SHR: 2.08, P&lt; 0.001), diarrhea (SHR: 1.70, P=0.034), gastroenteritis/colitis (SHR: 2.77, P=0.024), constipation (SHR: 1.62, P=0.001), and dehydration (SHR: 1.27, P=0.020). CONCLUSION Comparing to the RT alone group, elderly GBM patients received CRT had 4-month median OS benefit, but experienced significantly higher incidences of AEs.

neuro-oncology

EPID-16. COMPARATIVE ANALYSIS OF OVERALL SURVIVAL AND ADVERSE EVENTS BY ADJUVANT TREATMENT MODALITIES IN ELDERLY PATIENTS WITH GLIOBLASTOMA USING THE SEER-MEDICARE DATABASE