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Recommendations for the management of malignant gliomas in the
elderly
Basso U, Monfardini S, Brandes AA
Department of Oncology, Ospedale Busonera, Azienda
Ospedale-Universita, Padova, Italy. u.basso@tin.it
According to epidemiological estimations, the elderly are going to constitute an
increasing proportion of patients with gliomas in the near future.
Predominantly glioblastoma histology with invariably fatal outcome, disabling
comorbidities and presumed low tolerability of radiochemotherapeutic treatments
are the main reasons why elderly patients have been under-represented in the
majority of neuro-oncological clinical trials conducted so far.
Some small retrospective studies have reported that patients with good
performance status receiving surgery plus radiotherapy, and sometimes
chemotherapy, may achieve a survival comparable with that of younger patients,
however, in the absence of randomized studies, the balance of benefits and
adverse effects of aggressive treatments remains controversial.
Multidisciplinary evaluation of prognostic factors, such as performance status,
cognitive functions, tumor operability and burden of comorbidities, appears to
be mandatory in order to choose which patients must not be deprived of an
integrated treatment with surgery, full-dose radiotherapy and chemotherapy, and
which patients may reasonably be given a shorter radiotherapy plan, or even no
treatment at all due to the rapidly fatal course of their disease.
Peculiar features of malignant gliomas in the elderly and some practical
recommendations of management will be presented and discussed in this review.
PMID: 14599088 [PubMed - indexed for MEDLINE]
Source: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&list_uids=14599088&dopt=Abstract
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