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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
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Adult survivors of childhood cancer are 20 to 25 percent more likely to never marry compared with siblings and the general population, Yale School of Medicine researchers report in a new study published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research.
Brain tumors in childhood leave a lasting mark on cognition, life status
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Angiochem crosses BBB, shows safety, efficacy in phase 1/2 brain cancer studies
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Researchers report benefits of new standard treatment study for rare pediatric brain cancer
A team of researchers led by The University of Texas M. D. Anderson Cancer Center unveiled results today from the largest-ever collaborative study addressing the treatment of a rare pediatric brain tumor.
Unequal access: Hispanic children rarely get top-notch care for brain tumors
Hispanic children diagnosed with brain tumors get high-quality treatment at hospitals that specialize in neurosurgery far less often than other children with the same condition, potentially compromising their immediate prognosis and long-term survival, according to research from Johns Hopkins published in October's Pediatrics.
tudy: The new buzz on detecting tinnitus
It's a ringing, a buzzing, a hissing or a clicking - and the patient is the only one who can hear it. Complicating matters, physicians can rarely pinpoint the source of tinnitus, a chronic ringing of the head or ears that can be as quiet as a whisper or as loud as a jackhammer.
New Approach for the Treatment of Malignant Brain Tumors
Initial chemotherapy alone after surgery is just as successful as initial radiation therapy for patients from whom a very malignant brain tumor (anaplastic glioma) was removed. With this treatment, the patients survive on average > 30 months without a recurrence.
Weizmann Institute Scientists Discover A New Protein Partnership That Leads to Pediatric Tumor Regression
Why are some pediatric cancers able to spontaneously regress? Prof. Michael Fainzilber and his team of the Weizmann Institute's Biological Chemistry Department seem to have unexpectedly found part of the answer.
Why don't brain tumors respond to medication?
Malignant brain tumors often fail to respond to promising new medication. Researchers in Heidelberg have discovered a mechanism and a tumor marker for the development of this resistance.
NIH researchers identify key factor that stimulates brain cancer cells to spread
Researchers funded by the National Institutes of Health have found that the activity of a protein in brain cells helps stimulate the spread of an aggressive brain cancer called glioblastoma multiforme (GBM).
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