EBG MedAustron GmbH, Marie-Curie-Strasse 5, 2700, Wiener Neustadt, Austria.
Department of Neurosurgery, Medical University of Innsbruck, Innsbruck, Austria.
Curr Oncol Rep. 2020 Jul 10;22(9):93. doi: 10.1007/s11912-020-00951-6.
The incidence of glioblastoma multiforme (GBM) increases with age; more than half of newly diagnosed patients are older than 65 years. Due to age-dependent decreasing organ functions, comorbidities, functional decline, and increasing risk of social isolation, not all patients are able to tolerate standard therapy of GBM with 6 weeks of radiochemotherapy.
A set of alleviated therapies, e.g., chemotherapy or radiotherapy alone, hypofractionated radiotherapies with different total doses and variable fractionation regimens as well as hypofractionated radiotherapy with concomitant and adjuvant chemotherapy, have been evaluated during the last years. However, clinicians are still unsure which therapy would fit best to a given patient. Recently, the predictive value of comprehensive geriatric assessment regarding tolerance of chemotherapy and prediction of early mortality has been validated for older GBM patients in a retrospective trial. Thus, it appears that neuro-oncology is now ready for the prospective implementation of geriatric assessment to guide treatment planning for elderly GBM patients.
多形性胶质母细胞瘤(GBM)的发病率随年龄增长而增加;超过一半的新诊断患者年龄大于 65 岁。由于与年龄相关的器官功能下降、合并症、功能下降以及社会隔离风险增加,并非所有患者都能够耐受 6 周放射化学疗法的 GBM 标准治疗。
近年来,已经评估了一系列缓解疗法,例如单独化疗或放疗、不同总剂量的分次放射治疗和不同的分割方案,以及同时和辅助化疗的分次放疗。然而,临床医生仍不确定哪种疗法最适合特定患者。最近,一项回顾性试验验证了全面老年评估在预测化疗耐受性和早期死亡率方面对于老年 GBM 患者的预测价值。因此,神经肿瘤学似乎已经准备好前瞻性地实施老年评估,以指导老年 GBM 患者的治疗计划。