High-grade glioma in elderly patients: can the oncogeriatrician help?

Abstract

Emeline Tabouret,1 Louis Tassy,2 Olivier Chinot,1 ElodieCrétel,3 Frederique Retornaz,4 Frederique Rousseau5 1Department of Neuro-oncology, Timone Hospital, Marseille, France; 2Department of Medical Oncology, Centre Léon Bérard, Lyon, France; 3Transveral Oncogeriatric Unit, University Hospital Timone, Marseille, France; 4Departmental Gerontologic Center, Marseille, France; 5Department of Medical Oncology, Institut Paoli Calmettes, Marseille, France Abstract: Gliomas are the most frequent primary brain tumors in adults. As the population ages in Western countries, the number of people being diagnosed with glioblastoma is expected to increase. Clinical management of elderly patients with primary brain tumors is difficult, owing to multiple comorbidities, polypharmacy, decreased tolerance to chemotherapy, and an increased risk of radiation-induced neurotoxicity. A few specific randomized studies have shown a benefit for radiotherapy in elderly patients with good performance status. For patients with poor performance status, chemotherapy (temozolomide) has been shown to be associated with prolonged duration of response. Patients with methylated O6-alkylguanine deoxyribonucleic acid alkyltransferase promoter seem to have better outcomes. Oncogeriatrics proposes the geriatric evaluation of elderly patients to improve therapeutic choices and optimize the management of treatment toxicities and comorbidities. Keywords: brain tumor, older cancer patient, chemotherapy toxicity, oncogeriatric charter

Keywords

• brain tumor
• older cancer patient
• chemotherapy toxicity
• oncogeriatric charter