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 The purpose of this study was to evaluate the acute toxicity and the effectiveness of hypofractionated radiation therapy with concurrent temozolomide in terms of disease control in primary glioblastoma patients with poor prognostic factors.

we reviewed the treatment toxicities and overall survival of patients 65 years or older who were treated with chemoradiotherapy Between November 2013 and september 2021. Twelve elderly, and/or disabled patients received radiotherapy to a dose of 40.05 Gy in 15 fractions over 2 weeks, Treatment was delivered using VMAT technique. Simultaneously, 75 mg/m2/day of temozolomide were administered.

The median age at diagnosis was 73.5 years; median ECOG status  was 2. MGMT-methylation status was negative in 7 patients, and all patients were IDH-wildtype. Only 3 patients underwent complete surgical resection, three lesions were unresectable, 7 patients received combined TMZ, and could be completed according to schedule with no interruptions for blood toxicity.

Median PTV volume was 266.09cc.median OS = 8.5 months at the time of the study. 3 patients presented headaches and 7 fatigue, No acute grade 3-5 toxicities were documented. In this series of GBM cases, methylation of the MGMT gene promoter was not associated with longer survival.

Pseudoprogression has been reported in 3 patients and radiation necrosis no symptomatic was observed in one patient three month after treatment.

Patients with poor performance status and advanced age can be selected for hypofractionated radiotherapy. Short RT treatment seems equivalent to the traditional RT assuring good treatment adherence, low rates of toxicity, and probable improved cost-effectiveness.