[Glioblastoma in the elderly].

Area of Science:

• Neuro-oncology
• Geriatric Medicine
• Clinical Oncology

Context:

• Malignant gliomas incidence is increasing in the elderly.
• Age is a significant negative prognostic factor for glioma patients.
• Optimal management for elderly glioma patients is not well-established due to trial exclusion.

Purpose:

• To review current treatment strategies for malignant gliomas in the elderly.
• To highlight the evolving approach from nihilistic to active management.
• To identify areas needing further research and clinical trials.

Summary:

• Radiotherapy, including accelerated fractionation, has demonstrated benefits in older adults with malignant gliomas.
• The role of debulking surgery and chemotherapy (alone or with radiotherapy) is still under investigation.
• Symptomatic treatments like corticosteroids and antiepileptic drugs require careful consideration due to potential intolerance in the elderly.

Impact:

• This review informs clinical decision-making for elderly glioma patients.
• It emphasizes the need for patient-centered care, considering performance status, quality of life, and comorbidities.
• Highlights the critical need for prospective randomized trials to develop evidence-based treatment protocols for this demographic.