title: High-grade glioma in elderly patients: can the oncogeriatrician help?
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 O (6)-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.
authors.affiliation: Department of Neuro-oncology, Timone Hospital, Marseille, France.
authors.forename: Emeline
authors.initials: E
authors.lastname: Tabouret
authors.affiliation: Department of Medical Oncology, Centre Léon Bérard, Lyon, France.
authors.forename: Louis
authors.initials: L
authors.lastname: Tassy
authors.affiliation: Department of Neuro-oncology, Timone Hospital, Marseille, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Chinot
authors.affiliation: Transveral Oncogeriatric Unit, University Hospital Timone, Marseille, France.
authors.forename: Elodie
authors.initials: E
authors.lastname: Crétel
authors.affiliation: Departmental Gerontologic Center, Marseille, France.
authors.forename: Frederique
authors.initials: F
authors.lastname: Retornaz
authors.affiliation: Department of Medical Oncology, Institut Paoli Calmettes, Marseille, France.
authors.forename: Frederique
authors.initials: F
authors.lastname: Rousseau
mesh_terms: D000367:Age Factors; D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D003131:Combined Modality Therapy; D003606:Dacarbazine / Q000031:analogs & derivatives / Q000627:therapeutic use; D005910:Glioma / Q000175:diagnosis / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D006801:Humans; D011379:Prognosis; D000077204:Temozolomide
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide
keywords: brain tumor; chemotherapy toxicity; older cancer patient; oncogeriatric charter