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Drugs & Aging

, Volume 35, Issue 8, pp 707–718 | Cite as

Treatment of Glioblastoma in the Elderly

  • Rebecca A. Harrison
  • John F. de Groot
Review Article

Abstract

Clinical research in neuro-oncology frequently classifies patients over 60–70 years of age as ‘elderly’, a designation intended to identify patients with the disease characteristics, psychosocial changes, and susceptibility to treatment toxicities associated with advancing age. The elderly account for a large proportion of patients diagnosed with glioblastoma (GBM), and this population is projected to increase. Their prognosis is inferior to that of GBM patients as a whole, and concerns over treatment toxicity may limit the aggressiveness with which they are treated. Recent clinical studies have assisted with therapeutic decision making in this cohort. Hypofractionated radiation with concurrent and adjuvant temozolomide has been shown to increase survival without worsened quality of life in elderly patients with good functional status. Single modality radiation therapy or temozolomide therapy are frequently used in this population, and while neither has demonstrated superiority, O6-methylguanine–DNA methyltransferase (MGMT) methylation status is predictive of improved survival with temozolomide over radiation therapy. Despite these advances, ambiguity as to how to best define, assess, and treat this population remains. The specific response of elderly patients to emerging therapies, such as immunotherapies, is unclear. Advancing outcomes for elderly patients with GBM requires persistent efforts to include them in translational and clinical research endeavors, and concurrent dedication to the preservation of function and quality of life in this population.

Notes

Compliance with Ethical Standards

Funding

No external funding was used in the preparation of this manuscript.

Conflict of interest

Rebecca A. Harrison and John F. de Groot declare that they have no conflicts of interest that might be relevant to the contents of this manuscript.

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© Springer Nature Switzerland AG 2018

Authors and Affiliations

  1. 1.Department of Neuro-OncologyThe University of Texas MD Anderson Cancer CenterHoustonUSA

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