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Strahlentherapie von Hirntumoren im höheren Lebensalter

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Neurochirurgie bei älteren Patienten

Zusammenfassung

Die Häufigkeit von malignen und benignen Hirntumoren steigt mit zunehmendem Lebensalter an. Die Strahlentherapie allein oder in Kombination mit der Operation und/oder Chemotherapie ist eine wesentliche Komponente des multidisziplinären Managements von Hirntumoren. Aufgrund ihrer fehlenden Invasivität, der gezielten Anwendbarkeit sowie der Möglichkeit des relativ nebenwirkungsarmen Einsatzes an jeder anatomischen Lokalisation spielt sie gerade bei älteren Patienten, eine Schlüsselrolle in der Behandlung. Beim individuellen Therapieziel sind das Lebensalter, die Komorbidität und die funktionelle Reserve in der Nutzen-Risiko-Analyse zu berücksichtigen. Ein erhöhtes Lebensalter darf aber nicht dazu führen, dass diese Patienten keine ausreichende Behandlung erfahren. Durch moderne Präzisionstechniken und exakte Planung basierend auf hochauflösender Bildgebung ist es aber möglich, auch ältere Patienten sicher und mit geringen Nebenwirkungen effizient zu bestrahlen.

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Literatur

  • Achey RL, Gittleman H, Schroer J, Khanna V, Kruchko C, Barnholtz-Sloan JS (2019) Non-malignant and malignant meningioma incidence and survival in the elderly, 2005–2015, using the Central Brain Tumor Registry of the United States. Neuro Oncol 21:380–391

    Article  PubMed  Google Scholar 

  • Andrews DW, Scott CB, Sperduto PW, Flanders AE, Gaspar LE, Schell MC et al (2004) Whole brain radiation therapy with or without stereotactic radiosurgery boost for patients with one to three brain metastases: phase III results of the RTOG 9508 randomised trial. Lancet 363:1665–1672

    Article  PubMed  Google Scholar 

  • Aoyama H, Shirato H, Tago M, Nakagawa K, Toyoda T, Hatano K et al (2006) Stereotactic radiosurgery plus whole-brain radiation therapy vs stereotactic radiosurgery alone for treatment of brain metastases: a randomized controlled trial. JAMA 295:2483–2491

    Article  CAS  PubMed  Google Scholar 

  • Bielderman A, van der Schans CP, van Lieshout M-RJ, Hg de Greef M, Boersma F, Krijnen WP et al (2013) Multidimensional structure of the Groningen Frailty Indicator in community-dwelling older people. BMC Geriatr 13:86

    Article  PubMed  PubMed Central  Google Scholar 

  • Borgelt B, Gelber R, Kramer S, Brady LW, Chang CH, Davis LW et al (1980) The palliation of brain metastases: final results of the first two studies by the Radiation Therapy Oncology Group. Int J Radiat Oncol Biol Phys 6:1–9

    Article  CAS  PubMed  Google Scholar 

  • Bovi JA, Pugh SL, Sabsevitz D, Robinson CG, Paulson E, Mehta MP et al (2019) Pre-treatment volume of MRI-determined white matter injury predicts neurocognitive decline after hippocampal avoidant whole-brain radiation therapy for brain metastases: secondary analysis of NRG Oncology Radiation Therapy Oncology Group 0933. Adv Radiat Oncol 4:579–586

    Article  PubMed  PubMed Central  Google Scholar 

  • Bracci S, Laigle-Donadey F, Hitchcock K, Duran-Peña A, Navarro S, Chevalier A et al (2016) Role of irradiation for patients over 80 years old with glioblastoma: a retrospective cohort study. J Neurooncol 129:347–353

    Article  CAS  PubMed  Google Scholar 

  • Brandes AA, Franceschi E, Tosoni A, Benevento F, Scopece L, Mazzocchi V et al (2009) Temozolomide concomitant and adjuvant to radiotherapy in elderly patients with glioblastoma: correlation with MGMT promoter methylation status. Cancer 115:3512–3518

    Article  CAS  PubMed  Google Scholar 

  • Brown PD, Ballman KV, Cerhan JH, Anderson SK, Carrero XW, Whitton AC et al (2017) Postoperative stereotactic radiosurgery compared with whole brain radiotherapy for resected metastatic brain disease (NCCTG N107C/CEC.3): a multicenter, randomized, controlled, phase 3 trial. Lancet Oncol 18:1049–1060

    Article  PubMed  PubMed Central  Google Scholar 

  • Brown PD, Jaeckle K, Ballman KV, Farace E, Cerhan JH, Anderson SK et al (2016) Effect of radiosurgery alone vs radiosurgery with whole brain radiation therapy on cognitive function in patients with 1 to 3 brain metastases: a randomized clinical trial. JAMA 316:401–409

    Article  PubMed  PubMed Central  Google Scholar 

  • Caillet P, Laurent M, Bastuji-Garin S, Liuu E, Culine S, Lagrange JL et al (2014) Optimal management of elderly cancer patients: usefulness of the Comprehensive Geriatric Assessment. Clin Interv Aging 9:1645–1660

    PubMed  PubMed Central  Google Scholar 

  • Carreca I, Balducci L, Extermann M (2005) Cancer in the older person. Cancer Treat Rev 31:380–402

    Article  PubMed  Google Scholar 

  • Chang EL, Wefel JS, Hess KR, Allen PK, Lang FF, Kornguth DG et al (2009) Neurocognition in patients with brain metastases treated with radiosurgery or radiosurgery plus whole-brain irradiation: a randomized controlled trial. Lancet Oncol 10:1037–1044

    Article  PubMed  Google Scholar 

  • Combs SE, Farzin M, Boehmer J, Oehlke O, Molls M, Debus J et al (2018) Clinical outcome after high-precision radiotherapy for skull base meningiomas: Pooled data from three large German centers for radiation oncology. Radiother Oncol 127:274–279

    Article  PubMed  Google Scholar 

  • Extermann M (2012) Integrating a geriatric evaluation in the clinical setting. Semin Radiat Oncol 22:272–276

    Article  PubMed  Google Scholar 

  • Extermann M, Aapro M, Bernabei R, Cohen HJ, Droz JP, Lichtman S et al (2005) Use of comprehensive geriatric assessment in older cancer patients: recommendations from the task force on CGA of the International Society of Geriatric Oncology (SIOG). Crit Rev Oncol Hematol 55:241–252

    Article  PubMed  Google Scholar 

  • Flowers A (2000) Brain tumors in the older person. Cancer Control 7:523–538

    Article  CAS  PubMed  Google Scholar 

  • Fokas E, Henzel M, Surber G, Hamm K, Engenhart-Cabillic R (2014) Stereotactic radiation therapy for benign meningioma: long-term outcome in 318 patients. Int J Radiat Oncol Biol Phys 89:569–575

    Article  PubMed  Google Scholar 

  • Gondi V, Pugh SL, Tome WA, Caine C, Corn B, Kanner A et al (2014) Preservation of memory with conformal avoidance of the hippocampal neural stem-cell compartment during whole-brain radiotherapy for brain metastases (RTOG 0933): a phase II multi-institutional trial. J Clin Oncol 32:3810–3816

    Article  PubMed  PubMed Central  Google Scholar 

  • Gorlia T, van den Bent MJ, Hegi ME, Mirimanoff RO, Weller M, Cairncross JG et al (2008) Nomograms for predicting survival of patients with newly diagnosed glioblastoma: prognostic factor analysis of EORTC and NCIC trial 26981–22981/CE.3. Lancet Oncol 9:29–38

    Article  PubMed  Google Scholar 

  • Gu Y, Zhang J, Zhou Z, Liu D, Zhu H, Wen J et al (2020) Metastasis Patterns and Prognosis of Octogenarians with NSCLC: A Population-based Study. Aging Dis 11:82–92

    Article  PubMed  PubMed Central  Google Scholar 

  • Henzel M, Fokas E, Sitter H, Wittig A, Engenhart-Cabillic R (2013) Quality of life after stereotactic radiotherapy for meningioma: a prospective non-randomized study. J Neurooncol 113:135–141

    Article  PubMed  Google Scholar 

  • Hoffmann C, Distel L, Knippen S, Gryc T, Schmidt MA, Fietkau R et al (2018) Brain volume reduction after whole-brain radiotherapy: quantification and prognostic relevance. Neuro Oncol 20:268–278

    Article  PubMed  Google Scholar 

  • Hu YJ, Chen D, Zhang LF, Chen J (2019) Efficacy and safety of hypo fractionated stereotactic radiotherapy for recurrent malignant gliomas: a systematic review and meta-analysis. World Neurosurg 127:176–185

    Article  PubMed  Google Scholar 

  • Hurria A, Wildes T, Blair SL, Browner IS, Cohen HJ, Deshazo M et al (2014) Senior adult oncology, version 2.2014: clinical practice guidelines in oncology. J Natl Compr Canc Netw 12:82–126

    Article  PubMed  Google Scholar 

  • Ironside S, Das S, Sahgal A, Moroney C, Mainprize T, Perry JR (2017) Optimal therapies for newly diagnosed elderly patients with glioblastoma. Curr Treat Options Oncol 18:66

    Article  PubMed  Google Scholar 

  • Kaul D, Budach V, Graaf L, Gollrad J, Badakhshi H (2015) Outcome of Elderly Patients with Meningioma after Image-Guided Stereotactic Radiotherapy: A Study of 100 Cases. Biomed Res Int 2015:868401

    Article  PubMed  PubMed Central  Google Scholar 

  • Keime-Guibert F, Chinot O, Taillandier L, Cartalat-Carel S, Frenay M, Kantor G et al (2007) Radiotherapy for glioblastoma in the elderly. N Engl J Med 356:1527–1535

    Article  CAS  PubMed  Google Scholar 

  • Kocher M, Soffietti R, Abacioglu U, Villà S, Fauchon F, Baumert BG et al (2011) Adjuvant whole-brain radiotherapy versus observation after radiosurgery or surgical resection of one to three cerebral metastases: results of the EORTC 22952–26001 study. J Clin Oncol 29:134–141

    Article  PubMed  Google Scholar 

  • Kocher M, Wittig A, Piroth MD, Treuer H, Seegenschmiedt H, Ruge M et al (2014) Stereotactic radiosurgery for treatment of brain metastases. A report of the DEGRO Working Group on Stereotactic Radiotherapy. Strahlenther Onkol 190:521–532

    Article  PubMed  Google Scholar 

  • Kondziolka D, Mathieu D, Lunsford LD, Martin JJ, Madhok R, Niranjan A et al (2008) Radiosurgery as definitive management of intracranial meningiomas. Neurosurgery 62:53–58

    Article  PubMed  Google Scholar 

  • Kunkler ICH, Audisio R, Belkacemi Y, Betz M, Gore E, Hoffe S et al (2014) Review of current best practice and priorities for research in radiation oncology for elderly patients with cancer: The International Society of Geriatric Oncology (SIOG) task force. Ann Oncol 25:2134–2146

    Article  CAS  PubMed  Google Scholar 

  • Li J, Bentzen SM, Renschler M, Mehta MP (2007) Regression after whole-brain radiation therapy for brain metastases correlates with survival and improved neurocognitive function. J Clin Oncol 25:387–395

    Article  Google Scholar 

  • Lutterbach J, Bartelt S, Momm F, Becker G, Frommhold H, Ostertag C (2005) Is older age associated with a worse prognosis due to different patterns of care? A long-term study of 1346 patients with glioblastomas or brain metastases. Cancer 103:1234–1244

    Article  PubMed  Google Scholar 

  • Lutterbach J, Bartelt S, Stancu E, Guttenberger R (2002) Patients with brain metastases: hope for recursive partitioning analysis (RPA) class 3. Radiother Oncol 63:339–345

    Article  PubMed  Google Scholar 

  • Magnuson A, Allore H, Cohen HJ, Mohile SG, Williams GR, Chapman A et al (2016) Geriatric assessment with management in cancer care: Current evidence and potential mechanisms for future research. J Geriatr Oncol 7:242–248

    Article  PubMed  PubMed Central  Google Scholar 

  • Mahajan A, Ahmed S, McAleer MF, Weinberg JS, Li J, Brown P et al (2017) Post-operative stereotactic radiosurgery versus observation for completely resected brain metastases: a single-center, randomized, controlled, phase 3 trial. Lancet Oncol 18:1040–1048

    Article  PubMed  PubMed Central  Google Scholar 

  • Malmstrom A, Grønberg BH, Marosi C, Stupp R, Frappaz D, Schultz H et al (2012) Temozolomide versus standard 6-week radiotherapy versus hypo fractionated radiotherapy in patients older than 60 years with glioblastoma: the Nordic randomised, phase 3 trial. Lancet Oncol 13:916–926

    Article  PubMed  CAS  Google Scholar 

  • Mehta MP, Rodrigus P, Terhaard CHJ, Rao A, Suh J, Roa W et al (2003) Survival and neurologic outcomes in a randomized trial of motexafin gadolinium and whole-brain radiation therapy in brain metastases. J Clin Oncol 21:2529–2536

    Article  CAS  PubMed  Google Scholar 

  • Meyers CA, Smith JA, Bezjak A, Mehta MP, Liebmann J, Illidge T et al (2004) Neurocognitive function and progression in patients with brain metastases treated with whole-brain radiation and motexafin gadolinium: results of a randomized phase III trial. J Clin Oncol 22:157–165

    Article  CAS  PubMed  Google Scholar 

  • Milisen K, Hurria A (2014) International Society of Geriatric Oncology consensus on geriatric assessment in older patients with cancer. J Clin Oncol 32:2595–2603

    Article  PubMed  PubMed Central  Google Scholar 

  • Minniti G, Amichetti M, Enrici RM (2009) Radiotherapy and radiosurgery for benign skull base meningiomas. Radiat Oncol 4:42

    Article  PubMed  PubMed Central  Google Scholar 

  • Minniti G, Clarke E, Cavallo L, Osti MF, Esposito V, Cantore G et al (2011) Fractionated stereotactic conformal radiotherapy for large benign skull base meningiomas. Radiat Oncol 6:36

    Article  PubMed  PubMed Central  Google Scholar 

  • Minniti G, Filippi AR, Osti MF, Ricardi U (2017) Radiation therapy for older patients with brain tumors. Radiat Oncol 12:101

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Mishra MV, Showalter TN, Dicker AP (2012) Biomarkers of aging and radiation therapy tailored to the elderly: future of the field. Semin Radiat Oncol 22:334–338

    Article  PubMed  Google Scholar 

  • Molinaro AM, Taylor JW, Wiencke JK, Wrensch MR (2019) Genetic and molecular epidemiology of adult diffuse glioma. Nat Rev Neurol 15:405–417

    Article  PubMed  PubMed Central  Google Scholar 

  • Moraes FY, Lo A, Morgan ER, Millar BA, Shultz DB, Maurice C et al (2018) Management and outcomes in the oldest-old population with glioblastoma. Can J Neurol Sci 45:199–205

    Article  PubMed  Google Scholar 

  • Movsas B (2017) Radiation therapy in elderly persons: an old issue with new approaches. Int J Radiat Oncol Biol Phys 98:715–717

    Article  PubMed  Google Scholar 

  • Murray KJ, Scott C, Greenberg HM, Emami B, Seider M, Vora NL et al (1997) A randomized phase III study of accelerated hyper fractionation versus standard in patients with unresected brain metastases: a report of the Radiation Therapy Oncology Group (RTOG) 9104. Int J Radiat Oncol Biol Phys 39:71–574

    Article  Google Scholar 

  • Nayak L, Iwamoto FM (2010) Primary brain tumors in the elderly. Curr Neurol Neurosci Rep 10:252–258

    Article  PubMed  PubMed Central  Google Scholar 

  • NCCN Guidelines Version 3.2019-October 18,2019. https://www.nccn.org/store/login/login.aspx?ReturnURL=https://www.nccn.org/professionals/physician_gls/pdf/cns.pdf

  • Nassiri F, Taslimi S, Wang JZ, Badhiwala JH, Dalcourt T, Ijad N et al. (2020) Determining the optimal adjuvant therapy for improving survival in elderly patients with glioblastoma: a systematic review and meta-analysis. Clin Cancer Res 2020 Jan 17. doi: https://doi.org/10.1158/1078-0432.CCR-19-3359. Online ahead of print

  • Overcash JA, Beckstead J, Moody L, Extermann M, Cobb S (2006) The abbreviated comprehensive geriatric assessment (aCGA) for use in the older cancer patient as a prescreen: scoring and interpretation. Crit Rev Oncol Hematol 59:205–210

    Article  PubMed  Google Scholar 

  • Pallis AG, Gridelli C, Wedding U, Faivre-Finn C, Veronesi G, Jaklitsch M et al (2014) Management of elderly patients with NSCLC; updated expert’s opinion paper: EORTC Elderly Task Force, Lung Cancer Group and International Society for Geriatric Oncology. Ann Oncol 25:1270–1283

    Article  CAS  PubMed  Google Scholar 

  • Perry JR, Laperriere N, O’Callaghan CJ, Brandes AA, Menten J, Phillips C et al (2017) Short-course radiation plus temozolomide in elderly patients with glioblastoma. N Engl J Med 376:1027–1037

    Article  CAS  PubMed  Google Scholar 

  • Piccirilli M, Bistazzoni S, Gagliardi FM, Landi A, Santoro A, Giangaspero F et al (2006) Treatment of glioblastoma multiforme in elderly patients. Clinico-therapeutic remarks in 22 patients older than 80 years. Tumori 92:98–103

    Article  PubMed  Google Scholar 

  • Roa W, Brasher PMA, Bauman G, Anthes M, Bruera E, Chan A et al (2004) Abbreviated course of radiation therapy in older patients with glioblastoma multiforme: a prospective randomized clinical trial. J Clin Oncol 22:1583–1588

    Article  CAS  PubMed  Google Scholar 

  • Roa W, Kepka L, Kumar N, Sinaika V, Matiello J, Lomidze D et al (2015) International Atomic Energy Agency randomized phase III study of radiation therapy in elderly and/or frail patients with newly diagnosed glioblastoma multiforme. J Clin Oncol 33:4145–4150

    Article  PubMed  Google Scholar 

  • Santacroce A, Walier M, Régis J, Liščák R, Motti E, Lindquist C et al (2012) Long-term tumor control of benign intracranial meningiomas after radiosurgery in a series of 4565 patients. Neurosurgery 70:32–39

    Article  PubMed  Google Scholar 

  • Schmidt H, Boese S, Lampe K, Jordan K, Fiedler E, Müller-Werdan U et al (2017) Trans sectoral care of geriatric cancer patients based on comprehensive geriatric assessment and patient-reported quality of life - Results of a multicenter study to develop and pilot test a patient-centered interdisciplinary care concept for geriatric oncology patients (PIVOG). J Geriatr Oncol 8:262–270

    Article  PubMed  Google Scholar 

  • Shaw E, Scott C, Souhami L, Dinapoli R, Kline R, Loeffler J et al (2000) Single dose radiosurgical treatment of recurrent previously irradiated primary brain tumors and brain metastases: final report of RTOG protocol 90–05. Int J Radiat Oncol Biol Phys 47:291–298

    Article  CAS  PubMed  Google Scholar 

  • Shih YC, Hurria A (2014) Preparing for an epidemic: cancer care in an aging population. Am Soc Clin Oncol Educ Book 133–137.

    Google Scholar 

  • Smith GL, Smith BD (2014) Radiation treatment in older patients: a framework for clinical decision making. J Clin Oncol 32:2669–2678

    Article  PubMed  PubMed Central  Google Scholar 

  • Soffietti R, Kocher M, Abacioglu UM, Villa S, Fauchon F, Baumert BG et al (2013) A European Organisation for Research and Treatment of Cancer phase III trial of adjuvant whole-brain radiotherapy versus observation in patients with one to three brain metastases from solid tumors after surgical resection or radiosurgery: quality-of-life results. J Clin Oncol 31:65–72

    Article  PubMed  Google Scholar 

  • Soubeyran P, Bellera C, Goyard J, Heitz D, Curé H, Rousselot H et al (2014) Screening for vulnerability in older cancer patients: the ONCODAGE Prospective Multicenter Cohort Study. PLoS ONE 9:e115060

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Sperduto PW (2010) What is your patient’s GPA and why does it matter? Managing brain metastases and the cost of hope. Int J Radiat Oncol Biol Phys 77:643–644

    Article  PubMed  Google Scholar 

  • Sperduto PW, Kased N, Roberge D, Xu Z, Shanley R, Luo X et al (2012) Effect of tumor subtype on survival and the graded prognostic assessment for patients with breast cancer and brain metastases. Int J Radiat Oncol Biol Phys 82:2111–2117

    Article  PubMed  Google Scholar 

  • Steer CB, Brain EG (2016) Geriatric oncology and supportive care: A global approach to advance the science. J Geriatr Oncol 7:313–314

    Article  PubMed  Google Scholar 

  • Stupp R, Mason WP, van den Bent MJ, Weller M, Fisher B, Taphoorn MJ et al (2005) Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 352:987–996

    Article  CAS  PubMed  Google Scholar 

  • Tringale KR, Nguyen TT, Karunamuni R, Seibert T, Huynh-Le M-P, Connor M et al (2019) Quantitative imaging biomarkers of damage to critical memory regions are associated with post-radiation therapy memory performance in brain tumor Patients. Int J Radiat Oncol Biol Phys 105:773–783

    Article  PubMed  PubMed Central  Google Scholar 

  • VanderWalde N, Hurria A, Jagsi R (2017) Improving consistency and quality of Care for older adults with cancer: the challenges of developing consensus guidelines for radiation therapy. Int J Radiat Oncol Biol Phys 98:721–725

    Article  PubMed  Google Scholar 

  • Wahl DR, Nguyen PL, Santiago M, Yousefi K, Davicioni E, Shumway DA et al (2017) Pan-cancer analysis of genomic sequencing among the elderly. Int J Radiat Oncol Biol Phys 98:726–732

    Article  CAS  PubMed  Google Scholar 

  • Weller M, van den Bent M, Hopkins K, Tonn JC, Stupp R, Falini A et al (2014) EANO guideline for the diagnosis and treatment of anaplastic gliomas and glioblastoma. Lancet Oncol 15:e395-403

    Article  PubMed  Google Scholar 

  • Wick W, Platten M, Meisner C, Felsberg J, Tabatabai G, Simon M et al (2012) Temozolomide chemotherapy alone versus radiotherapy alone for malignant astrocytoma in the elderly: the NOA-08 randomized, phase 3 trial. Lancet Oncol 13:707–715

    Article  CAS  PubMed  Google Scholar 

  • Wildiers H, Heeren P, Puts M, Topinkova E, Janssen-Heijnen ML, Extermann M et al (2014) International Society of Geriatric Oncology consensus on geriatric assessment in older patients with cancer. J Clin Oncol 32:2595–2603

    Article  PubMed  PubMed Central  Google Scholar 

  • Yamamoto M, Serizawa T, Higuchi Y, Nagano O, Aiyama H, Koiso T et al (2018) Prognostic grading system specifically for elderly patients with brain metastases after stereotactic radiosurgery: a 2-institution study. J Neurosurg 129(Suppl1):95–102

    Article  PubMed  Google Scholar 

  • Yamamoto M, Serizawa T, Shuto T, Akabane A, Higuchi Y, Kawagishi J et al (2014) Stereotactic radiosurgery for patients with multiple brain metastases (JLGK0901): a multi-institutional prospective observational study. Lancet Oncol 15:387–395

    Article  PubMed  Google Scholar 

  • Zarnett OJ, Sahgal A, Gosio J, Perry J, Berger MS, Chang S et al (2015) Treatment of elderly patients with glioblastoma: a systematic evidence-based analysis. JAMA Neurol 72:589–596

    Article  PubMed  Google Scholar 

  • Zhou H, Bai HX, Chan L, Zhang PJ, Karakousis G, Huang R et al (2019) Survival benefit of adjuvant radiotherapy in elderly patients with WHO Grade III meningioma. World Neurosurg 131:e303–e311

    Article  PubMed  Google Scholar 

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  1. Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Jena, Jena, Deutschland

    Andrea Wittig & Marciana Nona Duma

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Correspondence to Andrea Wittig .

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  1. Neurochirurgische Klinik, Universitätsklinikum Gießen und Marburg GmbH, Standort Gießen, Gießen, Hessen, Germany

    Eberhard Uhl

  2. Klinik für Spinale Chirurgie, Schön Klinik Hamburg Eilbek, Hamburg, Germany

    Karsten Schöller

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Wittig, A., Duma, M.N. (2021). Strahlentherapie von Hirntumoren im höheren Lebensalter. In: Uhl, E., Schöller, K. (eds) Neurochirurgie bei älteren Patienten. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-60354-3_16

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