Brain Tumor Res Treat.  2022 Jan;10(1):12-21. 10.14791/btrt.2022.10.e34.

Radiotherapy for Newly Diagnosed Glioblastoma in the Elderly: What Is the Standard?

• Wee CW

• KMID: 2525297
• DOI: http://doi.org/10.14791/btrt.2022.10.e34

Abstract

Nearly half of the patients with newly diagnosed glioblastomas are aged ≥65 years. Unfortunately, these elderly patients with glioblastoma (GBM-e) demonstrate detrimental survival. However, the optimal treatment for GBM-e after surgery remains controversial. Conventionally fractionated radiotherapy (CFRT) of 60 Gy, hypofractionated radiotherapy (HFRT), temozolomide (TMZ), or a combination of these treatments with or without tumor treating fields can be considered. Although evidence has indicated a non-inferiority of HFRT compared to CFRT in GBM-e treated with radiotherapy (RT) alone throughout the past, the optimal RT scheme (CFRT vs. HFRT), when combined with TMZ, has never been investigated in a prospective randomized fashion for GBM-e patients suitable for radiochemotherapy. Several other issues make the treatment of GBM-e even more challenging. In this review, current evidence regarding RT in GBM-e, as well as issues that need to be addressed, is discussed.

Keyword

Glioblastoma; Elderly; Radiotherapy; Radiotherapy dose fractionation; Radiotherapy dose hypofractionation

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