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Study: Patients 75 years and older with brain tumors may benefit from more aggressive treatment
May 20, 2008Aggressive multi-modality treatments may lead to better outcomes
A new study from University Hospitals Case Medical Center (UHCMC) finds that elderly patients - 75 years old and older-- with malignant brain tumors are not treated as aggressively as patients between 65 and 75 years old. Furthermore, the researchers find that if patients over 75 years old are treated aggressively, such as with surgery and radiation, they have better survival rates. The findings appear in the April issue of the Journal of Neurosurgery.
Using the Surveillance, Epidemiology and End Results (SEER) Medicare-linked database, the researchers 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 malignant 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 incidence of these brain tumors is on the rise.
The researchers 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 treatment - 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, "Although 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 findings-seem to confirm findings from other retrospective and prospective analyses suggesting that treatment of elderly patients with GBM employing multimodal therapies does lead to superior outcomes without affecting their mental abilities or producing unbearable side effects."
University Hospitals of Cleveland
The researchers 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 treatment - 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, "Although 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 findings-seem to confirm findings from other retrospective and prospective analyses suggesting that treatment of elderly patients with GBM employing multimodal therapies does lead to superior outcomes without affecting their mental abilities or producing unbearable side effects."
University Hospitals of Cleveland
Brain Tumor Current Events and Brain Tumor News RSSNew approach to gene therapy may shrink brain tumors, prevent their spread
Massachusetts General Hospital (MGH) researchers are investigating a new approach to gene therapy for brain tumors - delivering a cancer-fighting gene to normal brain tissue around the tumor to keep it from spreading.
Family history of brain tumors linked to increased risk of brain cancer
People with a family history of cancerous brain tumors appear to be at higher risk of developing the same kind of tumors compared to people with no such family history.
Barrow researchers identify a new approach to detect the early progression of brain tumors
Researchers at Barrow Neurological Institute at St. Joseph's Hospital and Medical Center recently participated in a pilot study with the Montreal Neurological Institute that suggests a certain type of MRI scanning can detect when a patient is failing brain tumor treatment before symptoms appear.
Childhood brain tumor traced to normal stem cells gone bad
An aggressive childhood brain tumor known as medulloblastoma originates in normal brain "stem" cells that turn malignant when acted on by a known mutant, cancer-causing oncogene, say researchers from Dana-Farber Cancer Institute and the University of California, San Francisco (UCSF).
Erectile dysfunction drugs allowed more chemotherapy to reach brain tumors in laboratory study
In a study using laboratory animals, researchers found that medications commonly prescribed for erectile dysfunction opened a mechanism called the blood-brain tumor barrier and increased delivery of cancer-fighting drugs to malignant brain tumors.
Certain anticancer agents could be harmful to patients with heart disease
A set of promising new anticancer agents could have unforeseen risks in individuals with heart disease, suggests research at Washington University School of Medicine in St. Louis.
St. Jude finds young age may give survival advantage to children with certain brain tumors
St. Jude Children's Research Hospital investigators have shown that children under 3 years old who have a brain tumor called diffuse pontine glioma (DPG) appear to have a better outcome than older children with the same cancer.
Brown Chemists Create Cancer-Detecting Nanoparticles
A team led by a Brown University chemist has created the smallest iron oxide nanoparticles to date for cancer detection by magnetic resonance imaging (MRI). The magnetic nanoparticles operate like tiny guided missiles, seeking and attaching themselves to malignant tumor cells. Once they bind, the particles emit stronger signals that MRI scans can detect.
MRI: A window to genetic properties of brain tumors
Doctors diagnose and prescribe treatment for brain tumors by studying, under a microscope, tumor tissue and cell samples obtained through invasive biopsy or surgery.
Protein protects embryonic stem cells' versatility and self-renewal
A protein known as REST blocks the expression of a microRNA that prevents embryonic stem cells from reproducing themselves and causes them to differentiate into specific cell types, scientists at The University of Texas M. D. Anderson Cancer Center report in the journal Nature.
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