Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Department of Radiation Oncology and Image-Applied Therapy, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Jpn J Clin Oncol. 2022 Aug 5;52(8):833-842. doi: 10.1093/jjco/hyac075.
Optimizing the management of elderly patients with glioblastoma is an ongoing task in neuro-oncology. The number of patients with this tumor type is gradually increasing with the aging of the population. Although available data and practice recommendations remain limited, the current strategy is maximal safe surgical resection followed by radiotherapy in combination with temozolomide. However, survival is significantly worse than that in the younger population. Surgical resection provides survival benefit in patients with good performance status. Hypofractionated radiotherapy decreases toxicities while maintaining therapeutic efficacy, thus improving treatment adherence and subsequently leading to better quality of life. The intensity of these treatments should be balanced with patient-specific factors and consideration of quality of life. This review discusses the current optimal management in terms of efficacy and safety, as well as future perspectives.
优化老年胶质母细胞瘤患者的管理是神经肿瘤学中的一项持续任务。随着人口老龄化，此类肿瘤患者的数量逐渐增加。尽管现有数据和实践建议仍然有限，但目前的策略是最大限度地安全手术切除，然后联合替莫唑胺进行放疗。然而，与年轻患者相比，生存情况明显较差。对于身体状况良好的患者，手术切除可带来生存获益。分割剂量放疗可降低毒性，同时保持治疗效果，从而提高治疗依从性，进而提高生活质量。这些治疗的强度应与患者的具体情况和生活质量考虑相平衡。本文讨论了目前在疗效和安全性方面的最佳管理方法，以及未来的展望。
