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Multimodal strategy for managing meningiomas in the elderly
Y Sonoda1, K Sakurada, M Saino
1Department of Neurosurgery, Yamagata University School of Medicine, Yamagata, Japan.
Acta Neurochirurgica
|December 1, 2004
Summary
A multimodal strategy combining surgery, radiosurgery, and conservative management effectively treats brain tumors (meningiomas) in elderly patients, ensuring good tumor control and maintaining daily life activities.
Area of Science:
- Neurosurgery
- Oncology
- Geriatrics
Background:
- Increasing incidence of brain tumors in the elderly population.
- Established treatment modalities for meningiomas in older adults.
- Development of a multimodal treatment strategy for elderly meningioma patients.
Purpose of the Study:
- To evaluate the efficacy and safety of a multimodal treatment strategy for meningiomas in elderly patients.
- To assess outcomes including tumor control, mortality, and patient quality of life.
Main Methods:
- A cohort of 35 elderly patients with meningiomas was registered.
- Treatment approaches included surgery for symptomatic tumors, conservative management for asymptomatic tumors with delayed surgery if progression occurred, and gamma knife radiosurgery for residual or recurrent tumors.
- Patient outcomes were assessed using Karnofsky scale and tumor size monitoring.
Main Results:
- Surgical mortality was 4% and morbidity was 16%.
- 84% of surgically treated patients achieved a good Karnofsky score (> or =80%) at discharge.
- Conservative management of asymptomatic meningiomas showed stability in 9 out of 11 cases, and radiosurgery demonstrated excellent tumor control for residual/recurrent cases.
Conclusions:
- Meningiomas in elderly patients necessitate a multimodal treatment approach.
- The integrated strategy of surgery, radiosurgery, and conservative management yields favorable tumor control.
- This approach enables elderly patients to maintain their daily activities.