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Surgery for Glioblastoma in Elderly Patients
Marco Conti Nibali1, Lorenzo G Gay1, Tommaso Sciortino1
1Department of Oncology and Hemato-Oncology, Via Festa del Perdono 7, Milan 20122, Italy; IRCCS Istituto Ortopedico Galeazzi, Neurochirurgia Oncologica, Milan, Italy.
Neurosurgery Clinics of North America
|November 23, 2020
Summary
Glioblastoma management in older adults prioritizes biological age over chronological age. Treatment decisions should consider patient performance and O6-methylguanine-DNA methyl-transferase (MGMT) methylation status.
Area of Science:
- Neuro-oncology
- Geriatric medicine
- Cancer treatment
Background:
- Glioblastoma management in the elderly is increasingly important due to rising life expectancy.
- Biological age, not chronological age, is a critical factor in this demographic.
- Current treatment access may be unfairly limited by chronological age.
Purpose of the Study:
- To emphasize the importance of biological age in elderly glioblastoma patients.
- To advocate for treatment access regardless of chronological age.
- To outline optimal management strategies for elderly glioblastoma patients.
Main Methods:
- Review of current glioblastoma management principles in elderly populations.
- Emphasis on patient performance status and general health.
- Consideration of O6-methylguanine-DNA methyl-transferase (MGMT) methylation status.
Main Results:
- Maximal safe resection is the primary treatment option for patients with good performance status.
- Adjuvant therapy decisions require multidisciplinary evaluation.
- Recurrence management should be individualized based on patient performance and MGMT methylation.
Conclusions:
- Treatment decisions for elderly glioblastoma patients must be personalized.
- Biological age and patient-specific factors are paramount.
- MGMT methylation status is a key determinant in treatment and recurrence management.
