Primary brain tumors in the elderly Journal Article
| Authors: | Nayak, L.; Iwamoto, F. M. |
| Article Title: | Primary brain tumors in the elderly |
| Abstract: | The incidence of primary brain tumors is highest in elderly patients, and advanced age often is a negative prognostic factor. Nevertheless, large randomized studies in this population are scarce. Elderly patients with primary brain tumors also present unique challenges, such as the presence of multiple comorbidities and polypharmacy, decreased tolerance to chemotherapy, and an increased risk for radiation-induced neurotoxicity. This review gives an overview of the treatment options for older patients with glioblastoma and other gliomas, primary central nervous system lymphomas (PCNSLs), and meningiomas. Selected elderly glioblastoma patients with good performance status may benefit from aggressive treatment with surgical resection, radiotherapy, and possibly chemotherapy. For older patients with PCNSLs, high-dose methotrexate-based chemotherapy should be the mainstay option; whole-brain radiation therapy should be avoided in chemosensitive tumors because of the high risk of irreversible and progressive neurotoxicity. Meningiomas often may be followed up in elderly patients, as they usually are asymptomatic and have a slow growth rate. Treatment for elderly patients with primary brain tumors should be individualized, and age alone should not preclude the use of more aggressive treatments. © US Government 2010. |
| Keywords: | cancer survival; treatment outcome; aged; aged, 80 and over; clinical trial; review; bevacizumab; cancer combination chemotherapy; monotherapy; cancer adjuvant therapy; cancer radiotherapy; chemotherapy; primary central nervous system lymphoma; cytarabine; methotrexate; temozolomide; brain radiation; drug megadose; neurotoxicity; brain tumor; glioma; brain neoplasms; antineoplastic agent; cancer incidence; multiple cycle treatment; diagnosis, differential; blood toxicity; radiotherapy; differential diagnosis; vincristine; pathology; carmustine; lomustine; procarbazine; age; glioblastoma; drug response; oligodendroglioma; methylprednisolone; stereotactic radiosurgery; meningioma; external beam radiotherapy; corticosteroid; brain biopsy; elderly care; astrocytoma; elderly; brain surgery; primary brain tumor |
| Journal Title: | Current Neurology and Neuroscience Reports |
| Volume: | 10 |
| Issue: | 4 |
| ISSN: | 1528-4042 |
| Publisher: | Springer |
| Date Published: | 2010-07-01 |
| Start Page: | 252 |
| End Page: | 258 |
| Language: | English |
| DOI: | 10.1007/s11910-010-0110-x |
| PUBMED: | 20461477 |
| PROVIDER: | scopus |
| PMCID: | PMC7398448 |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 1" - "Export Date: 20 April 2011" - "CODEN: CNNRB" - "Source: Scopus" |
