Patients 75 years and older with brain tumors

Patients 75 years and older with brain tumors

A new study from University Hospitals Case Medical Center (UHCMC) finds that elderly patients 75 years old and older-- with cancerous brain tumors are not treated as aggressively as patients between 65 and 75 years old. Furthermore, the scientists find that if patients over 75 years old are treated aggressively, such as with surgery and radiation, they have better survival rates. The findings are reported in the recent issue of the Journal of Neurosurgery.

Using the Surveillance, Epidemiology and End Results (SEER) Medicare-linked database, the scientists led by Jill S. Barnholtz-Sloan, Ph.D., of the Comprehensive Cancer Center at Case Western Reserve University and University Hospitals, looked at the records of 1753 patients who were treated for glioblastoma multiforme (GBM) and of 205 patients treated for anaplastic astrocytoma (AA) between 1991 and 1999. GBMs are the most common cancerous brain tumors in adults. AAs are less common, but are treated similarly to GBMs. Both have a poor prognosis, and as the American population ages, the occurence rate of these brain tumors is on the rise.

The scientists looked at whether patients received a biopsy only, surgery only, biopsy and radiation, surgery and radiation, or surgery, radiation and chemotherapy.

The odds of undergoing aggressive therapy surgery followed by radiation with or without chemotherapy, which is the standard of care in the United States in younger individuals decreased significantly in individuals who were 75 years old or older, said Dr. Barnholtz-Sloan.

These findings suggest that older patients with brain tumors do not receive the more aggressive, effective therapies and hence have worse survival, she said.

Andrew Sloan, M.D., senior author and a neurological cancer surgeon in the Neurological Institute and Ireland Cancer Center at UHCMC, said, Eventhough there has been a reluctance to aggressively treat elderly patients, this study suggests that neurosurgeons and neuro-oncologists may need to re-examine their approach to these patients.

In an accompanying editorial, E. Antonio Chiocca, M.D., Ph.D., of the James Comprehensive Cancer Center at The Ohio State University Medical Center, writes, The findingsseem to confirm findings from other retrospective and prospective analyses suggesting that therapy of elderly patients with GBM employing multimodal therapies does lead to superior outcomes without affecting their mental abilities or producing unbearable side effects.