Current Neurology and Neuroscience Reports

, Volume 10, Issue 4, pp 252–258

Primary Brain Tumors in the Elderly

Authors

  • Lakshmi Nayak
    • Department of NeurologyMemorial Sloan-Kettering Cancer Center
    • Neuro-Oncology BranchNational Cancer Institute, National Institute of Neurological Disorders and Stroke, National Institutes of Health
Article

DOI: 10.1007/s11910-010-0110-x

Cite this article as:
Nayak, L. & Iwamoto, F.M. Curr Neurol Neurosci Rep (2010) 10: 252. doi:10.1007/s11910-010-0110-x

Abstract

The incidence of primary brain tumors is highest in elderly patients, and advanced age often is a negative prognostic factor. Nevertheless, large randomized studies in this population are scarce. Elderly patients with primary brain tumors also present unique challenges, such as the presence of multiple comorbidities and polypharmacy, decreased tolerance to chemotherapy, and an increased risk for radiation-induced neurotoxicity. This review gives an overview of the treatment options for older patients with glioblastoma and other gliomas, primary central nervous system lymphomas (PCNSLs), and meningiomas. Selected elderly glioblastoma patients with good performance status may benefit from aggressive treatment with surgical resection, radiotherapy, and possibly chemotherapy. For older patients with PCNSLs, high-dose methotrexate-based chemotherapy should be the mainstay option; whole-brain radiation therapy should be avoided in chemosensitive tumors because of the high risk of irreversible and progressive neurotoxicity. Meningiomas often may be followed up in elderly patients, as they usually are asymptomatic and have a slow growth rate. Treatment for elderly patients with primary brain tumors should be individualized, and age alone should not preclude the use of more aggressive treatments.

Keywords

Elderly Glioma Glioblastoma Oligodendroglioma Astrocytoma Primary central nervous system lymphoma Meningioma Primary brain tumor Chemotherapy Radiotherapy

Copyright information

© US Government 2010