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Elderly cancer patients are an important challenge in oncology, and clinical data from younger populations cannot be automatically considered applicable to unselected elderly patients with brain tumors, who tend to have more comorbidities and tolerate chemotherapy and radiotherapy less well than their younger counterparts. Most data available on elderly cancer patients are from retrospective studies that do not include age-specific enrollment criteria and are biased by intrinsic selection criteria governing enrollment. Most clinicians are unwilling to enroll elderly patients because of ageism and a fear of toxicity and poor outcome. Specifically designed trials based on genetic features and clinical factors are required to clearly establish the standard of care required for elderly patients with brain tumors, especially those with glioblastoma. Currently, surgery followed by radiotherapy is widely used for elderly glioblastoma patients, but temozolomide is the chemotherapeutic approach of choice for those with a relatively good clinical condition and prognosis. However, the schedule to follow and the best dosage have yet to be satisfactorily established.
Department of Medical Oncology, Bellaria-Maggiore Hospital, Azienda USL of Bologna, Via Altura 3, 40139, Bologna, Italy, email@example.com.
This article was published in the following journal.
Name: Current treatment options in neurology
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Neoplasms of the intracranial components of the central nervous system, including the cerebral hemispheres, basal ganglia, hypothalamus, thalamus, brain stem, and cerebellum. Brain neoplasms are subdivided into primary (originating from brain tissue) and secondary (i.e., metastatic) forms. Primary neoplasms are subdivided into benign and malignant forms. In general, brain tumors may also be classified by age of onset, histologic type, or presenting location in the brain.
Neoplasms located in the brain ventricles, including the two lateral, the third, and the fourth ventricle. Ventricular tumors may be primary (e.g., CHOROID PLEXUS NEOPLASMS and GLIOMA, SUBEPENDYMAL), metastasize from distant organs, or occur as extensions of locally invasive tumors from adjacent brain structures.
Benign and malignant intra-axial tumors of the MESENCEPHALON; PONS; or MEDULLA OBLONGATA of the BRAIN STEM. Primary and metastatic neoplasms may occur in this location. Clinical features include ATAXIA, cranial neuropathies (see CRANIAL NERVE DISEASES), NAUSEA, hemiparesis (see HEMIPLEGIA), and quadriparesis. Primary brain stem neoplasms are more frequent in children. Histologic subtypes include GLIOMA; HEMANGIOBLASTOMA; GANGLIOGLIOMA; and EPENDYMOMA.
A BRAIN-specific hyalectin that may play a role in terminally differentiating NEURONS. It is found highly overexpressed in primary BRAIN TUMORS and in experimental models of GLIOMA.
Intracranial tumors originating in the region of the brain inferior to the tentorium cerebelli, which contains the cerebellum, fourth ventricle, cerebellopontine angle, brain stem, and related structures. Primary tumors of this region are more frequent in children, and may present with ATAXIA; CRANIAL NERVE DISEASES; vomiting; HEADACHE; HYDROCEPHALUS; or other signs of neurologic dysfunction. Relatively frequent histologic subtypes include TERATOMA; MEDULLOBLASTOMA; GLIOBLASTOMA; ASTROCYTOMA; EPENDYMOMA; CRANIOPHARYNGIOMA; and choroid plexus papilloma (PAPILLOMA, CHOROID PLEXUS).
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