Laigle-Donadey F, Navarro S, Delattre J-Y
Service de neurologie Mazarin, hôpital de la Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France.
Rev Neurol (Paris). 2008 Jun-Jul;164(6-7):542-6. doi: 10.1016/j.neurol.2008.03.013. Epub 2008 May 13.
The incidence of malignant gliomas is growing in the elderly population. Unfortunately, increasing age is one of the most important negative prognostic factors in gliomas and the optimal management of this population remains largely unsettled because older patients are often excluded from clinical trials. However, the classic nihilistic approach is progressively changing towards more active strategies. Particularly, prospective randomized studies have recently established the benefit of radiation therapy and the validity of an accelerated course of radiation in older patients suffering from malignant gliomas. The interest of chemotherapy, alone or concomitant with radiation therapy is still under evaluation in this population. Initial performance status, quality of life and concomitant pathologies are important factors to consider before treatment onset. In the future, it will be necessary to develop specific schedules of treatment in this population.
恶性胶质瘤在老年人群中的发病率正在上升。不幸的是,年龄增长是胶质瘤最重要的负面预后因素之一,由于老年患者通常被排除在临床试验之外,这部分人群的最佳治疗方案在很大程度上仍未确定。然而,传统的消极方法正逐渐转向更积极的策略。特别是,前瞻性随机研究最近证实了放疗的益处以及加速放疗疗程在老年恶性胶质瘤患者中的有效性。化疗单独使用或与放疗联合使用在这部分人群中的效果仍在评估中。治疗开始前,初始身体状况、生活质量和伴随疾病是需要考虑的重要因素。未来,有必要为这部分人群制定特定的治疗方案。