Advances in the treatment of glioblastoma in older adults

doi:10.3877/cma.j.issn.2095-8757.2018.01.007

Abstract

Abstract:

Glioblastoma is the most common primary malignant brain tumor in adults. More than half of newly diagnosed glioblastoma patients are over 65 years old. The current standard treatment for glioblastoma is surgical resection, followed by concurrent chemoradiotherapy. There is no consensus recommendation regarding the best available treatment for glioblastoma in elderly patients due to the individual specificity and tumor heterogeneity. This review discussed the management of glioblastoma in elderly patients including surgery, chemoradiotherapy, and immunotherapy, in order to provide a reference for the development of a reasonable treatment regimen for elderly patients with glioblastoma.

Key words: Glioblastoma, Surgical procedures, Operative, Radiotherapy, Chemotherapy, Research progress

Ganlu Zhang, Hao Jiang. Advances in the treatment of glioblastoma in older adults[J]. Chinese Journal of Geriatrics Research(Electronic Edition), 2018, 05(01): 37-42.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhlnbyjdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-8757.2018.01.007

https://zhlnbyjdzzz.cma-cmc.com.cn/EN/Y2018/V05/I01/37

References 50

[1]	Ostrom QT,Gittleman H,Farah P, et al. CBTRUS statistical report: Primary brain and central nervous system tumors diagnosed in the United States in 2006-2010[J].Neuro Oncol, 2013, 15 Suppl 2:ii1-56.
[2]	Zinn PO,Colen RR,Kasper EM, et al. Extent of resection and radiotherapy in GBM: A 1973 to 2007 surveillance, epidemiology and end results analysis of 21,783 patients[J]. Int J Oncol, 2013, 42(3):929-934.
[3]	Darefsky AS,King JT,Dubrow R. Adult glioblastoma multiforme survival in the temozolomide era: a population-based analysis of Surveillance, Epidemiology, and End Results registries[J]. Cancer, 2012, 118(8):2163-2172.
[4]	Morgan ER,Norman A,Laing K, et al. Treatment and outcomes for glioblastoma in elderly compared with non-elderly patients: a population-based study[J]. Curr Oncol, 2017, 24(2):e92-e98.
[5]	Ostrom QT,Gittleman H,Fulop J, et al. CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2008-2012[J]. Neuro Oncol, 2015, 17 Suppl 4:iv1-iv62.
[6]	Roa W,Xing JZ,Small C, et al. Current developments in the radiotherapy approach to elderly and frail patients with glioblastoma multiforme[J]. Expert Rev Anticancer Ther, 2009, 9(11):1643-1650.
[7]	Buckner JC. Factors influencing survival in high-grade gliomas[J]. Semin Oncol, 2003, 30 (6 Suppl 19):10-14.
[8]	Stupp R,Mason WP,van den Bent MJ, et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma[J]. N Engl J Med, 2005, 352(10):987-996.
[9]	Roh TH,Park HH,Kang SG, et al. Long-term outcomes of concomitant chemoradiotherapy with temozolomide for newly diagnosed glioblastoma patients: A single-center analysis[J]. Medicine (Baltimore), 2017, 96(27):e7422.
[10]	Filippini G,Falcone C,Boiardi A, et al. Prognostic factors for survival in 676 consecutive patients with newly diagnosed primary glioblastoma[J]. Neuro Oncol, 2008, 10(1):79-87.
[11]	Hartmann C,Hentschel B,Wick W, et al. Patients with IDH1 wild type anaplastic astrocytomas exhibit worse prognosis than IDH1-mutated glioblastomas, and IDH1 mutation status accounts for the unfavorable prognostic effect of higher age: implications for classification of gliomas[J]. Acta Neuropathol, 2010, 120(6):707-718.
[12]	Cohen AL,Holmen SL,Colman H. IDH1 and IDH2 mutations in gliomas[J]. Curr Neurol Neurosci Rep, 2013, 13(5):345.
[13]	Weller M,Platten M,Roth P, et al. Geriatric neuro-oncology: from mythology to biology[J]. Curr Opin Neurol, 2011, 24(6): 599-604.
[14]	Fiorentino A,Balducci M,De Bonis P, et al. Can elderly patients with newly diagnosed glioblastoma be enrolled in radiochemotherapy trials[J]? Am J Clin Oncol, 2015, 38(1): 23-27.
[15]	álvarez de Eulate-Beramendi S,álvarez-Vega MA,Balbin M, et al. Prognostic factors and survival study in high-grade glioma in the elderly[J]. Br J Neurosurg, 2016, 30(3):330-336.
[16]	Scott JG,Bauchet L,Fraum TJ, et al. Recursive partitioning analysis of prognostic factors for glioblastoma patients aged 70 years or older[J]. Cancer, 2012, 118(22):5595-5600.
[17]	Young JS,Chmura SJ,Wainwright DA, et al. Management of glioblastoma in elderly patients[J]. J Neurol Sci, 2017, 380:250-255.
[18]	Zarnett OJ,Sahgal A,Gosio J, et al. Treatment of elderly patients with glioblastoma: a systematic evidence-based analysis[J]. JAMA Neurol, 2015, 72(5):589-596
[19]	Stupp R,Hegi ME,Mason WP, et al. Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trial[J]. Lancet Oncol, 2009, 10(5):459-466.
[20]	Lasocki A,Gaillard F,Tacey M, et al. Morphologic patterns of noncontrast-enhancing tumor in glioblastoma correlate with IDH1 mutation status and patient survival[J]. J Clin Neurosci, 2018, 47:168-173.
[21]	Hegi ME,Stupp R. Neuro-oncology: in search of molecular markers of glioma in elderly patients[J]. Nat Rev Neurol, 2013, 9(8):424-425.
[22]	Wiestler B,Claus R,Hartlieb SA, et al. Malignant astrocytomas of elderly patients lack favorable molecular markers: an analysis of the NOA-08 study collective[J]. Neuro Oncol, 2013, 15(8):1017-1026.
[23]	Minniti G,Scaringi C,Lanzetta G, et al. Standard (60 Gy) or short-course (40 Gy) irradiation plus concomitant and adjuvant temozolomide for elderly patients with glioblastoma: a propensity-matched analysis[J]. Int J Radiat Oncol Biol Phys, 2015, 91(1):109-115.
[24]	Hegi ME,Diserens AC,Gorlia T, et al. MGMT gene silencing and benefit from temozolomide in glioblastoma[J]. N Engl J Med, 2005, 352(10):997-1003.
[25]	Wainwright DA,Balyasnikova IV,Chang AL, et al. IDO expression in brain tumors increases the recruitment of regulatory T cells and negatively impacts survival[J]. Clin Cancer Res, 2012, 18(22):6110-6121.
[26]	Reifenberger G,Hentschel B,Felsberg J, et al. Predictive impact of MGMT promoter methylation in glioblastoma of the elderly[J]. Int J Cancer, 2012, 131(6):1342-1350.
[27]	Batchelor TT,Betensky RA,Esposito JM, et al. Age-dependent prognostic effects of genetic alterations in glioblastoma[J]. Clin Cancer Res, 2004, 10(1 Pt 1):228-233.
[28]	Chargari C,Feuvret L,Bauduceau O, et al. Treatment of elderly patients with glioblastoma: from clinical evidence to molecular highlights[J]. Cancer Treat Rev, 2012, 38(8):988-995.
[29]	Ladomersky E,Zhai L,Gritsina G, et al. Advanced age negatively impacts survival in an experimental brain tumor model[J]. Neurosci Lett, 2016, 630:203-208.
[30]	Vuorinen V,Hinkka S,FärkkiläM, et al. Debulking or biopsy of malignant glioma in elderly people - a randomised study[J]. Acta Neurochir (Wien), 2003, 145(1):5-10.
[31]	Malmström A,Grønberg BH,Marosi C, et al. Temozolomide versus standard 6-week radiotherapy versus hypofractionated radiotherapy in patients older than 60 years with glioblastoma: the Nordic randomised, phase 3 trial[J]. Lancet Oncol, 2012, 13(9):916-926.
[32]	Wick W,Platten M,Meisner C, et al. Temozolomide chemotherapy alone versus radiotherapy alone for malignant astrocytoma in the elderly: the NOA-08 randomised, phase 3 trial[J].Lancet Oncol, 2012, 13(7):707-715.
[33]	Rigamonti A,Imbesi F,Silvani A, et al. Pattern of care and outcome in elderly patients with glioblastoma: Data in 151 patients from 3 Lombardia hospitals[J]. Neuro Sci, 2017, 378:3-8.
[34]	Almenawer SA,Badhiwala JH,Alhazzani W, et al. Biopsy versus partial versus gross total resection in older patients with high-grade glioma: a systematic review and meta-analysis[J]. Neuro Oncol, 2015, 17(6):868-881.
[35]	Babu R,Komisarow JM,Agarwal VJ, et al. Glioblastoma in the elderly: the effect of aggressive and modern therapies on survival[J]. J Neurosurg, 2016, 124(4):998-1007.
[36]	Chaichana KL,Chaichana KK,Olivi A, et al. Surgical outcomes for older patients with glioblastoma multiforme: preoperative factors associated with decreased survival.Clinical article[J]. J Neurosurg, 2011, 114(3):587-594.
[37]	Tanaka S,Meyer FB,Buckner JC, et al. Presentation, management, and outcome of newly diagnosed glioblastoma in elderly patients[J]. J Neurosurg, 2013, 118(4):786-798.
[38]	Keime-Guibert F,Chinot O,Taillandier L, et al. Radiotherapy for glioblastoma in the elderly[J]. N Engl J Med, 2007, 356(15): 1527-1535.
[39]	Scott J,Tsai YY,Chinnaiyan P, et al. Effectiveness of radiotherapy for elderly patients with glioblastoma[J]. Int J Radiat Oncol Biol Phys, 2011, 81(1):206-210.
[40]	Roa W,Brasher PM,Bauman G, et al. Abbreviated course of radiation therapy in older patients with glioblastoma multiforme: a prospective randomized clinical trial[J]. J Clin Oncol, 2004, 22(9):1583-1588.
[42]	Gállego Pérez-Larraya J,Ducray F,Chinot O, et al. Temozolomide in elderly patients with newly diagnosed glioblastoma and poor performance status: an ANOCEF phase II trial[J]. J Clin Oncol, 2011, 29(22):3050-3055.
[43]	Binabaj MM,Bahrami A,ShahidSales S, et al. The prognostic value of MGMT promoter methylation in glioblastoma: A meta-analysis of clinical trials[J]. J Cell Physiol, 2018, 233(1):378-386.
[44]	Chang-Halpenny CN,Yeh J,Lien WW. Elderly patients with glioblastoma multiforme treated with concurrent temozolomide and standard- versus abbreviated-course radiotherapy[J]. The Permanente Journal, 2015, 19(1):15-20.
[45]	Yin AA,Cai S,Dong Y, et al. A meta-analysis of temozolomide versus radiotherapy in elderly glioblastoma patients[J]. J Neurooncol, 2014, 116(2):315-324.
[46]	Huang J,Samson P,Perkins SM, et al. Impact of concurrent chemotherapy with radiation therapy for elderly patients with newly diagnosed glioblastoma: a review of the National Cancer Data Base[J]. J Neurooncol, 2017, 131(3):593-601.
[47]	Metcalfe E,Karaoglanoglu O,Akyazici E. Radiotherapy with or without temozolomide in elderly patients aged≥70 years with glioblastoma[J]. Contemp Oncol (Pozn), 2016, 20(3):251-255.
[48]	Greer L,Pannullo SC,Smith AW, et al. Accelerated hypofractionated radiotherapy in the era of concurrent temozolomide chemotherapy in elderly patients with glioblastoma multiforme[J]. Cureus, 2017, 9(6):e1388.
[49]	Perry JR,Laperriere N,O'Callaghan CJ, et al. Short-course radiation plus temozolomide in elderly patients with glioblastoma[J]. N Engl J Med, 2017, 376(11):1027-1037.
[50]	Dunn-Pirio AM,Vlahovic G. Immunotherapy approaches in the treatment of malignant brain tumors[J].Cancer, 2017, 123(5):734-750.

Please choose a citation manager

Content to export