Radiotherapy in Geriatric Central Nervous System Cancer Patients

radyasyon_onkolojisi_102

Meltem KIRLI BÖLÜKBAŞa , Celalettin EROĞLUb
aUniversity of Health Sciences Bakırköy Dr. Sadi Konuk Training and Research Hospital, Department of Radiation Oncology, İstanbul, Türkiye
bErciyes University Faculty of Medicine, Department of Radiation Oncology, Kayseri, Türkiye

Kırlı Bölükbaş M, Eroğlu C. Radiotherapy in geriatric central nervous system cancer patients. In: Metcalfe E, ed. Radiotherapy and Current Developments in Geriatric Cancers. 1st ed. Ankara: Türkiye Klinikleri; 2024. p.1-8.

ABSTRACT
The place of radiotherapy (RT) for the Central Nervous System (CNS) tumors in elderly patients depends on factors such as tumor type, size, location, and the patient’s performance status. The efficacy and tolerability of RT and the dose-fractionation scheme chosen may differ in younger patients. Side effects of RT in elderly patients may have a greater impact, especially on neurological and cognitive functions. It has been shown that alternative treatment approaches, such as hypofractionated RT and temozolomide may offer survival benefits similar to standard treatments for glial tumors in the geriatric population. RT may be considered when surgery is not suitable or in grade II-III histologies in the treatment of meningiomas. Stereotactic radiosurgery (SRS) is generally the method of choice and is well tolerated in elderly patients with low toxicity and high local control rates. Brain metastases are also often seen in elderly and frail patients, and SRS is an effective treatment option in this group of patients. Consequently, it is important to take an individualized approach to the use of RT for CNS tumors in elderly patients.

Keywords: Elderly; glioblastoma; meningioma; radiaton dose hypofractionation; stereotactic radiation

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