Gliomas in the elderly

The incidence of malignant gliomas is growing in the elderly population. Unfortunately, increasing age is one of the most important negative prognostic factors in gliomas and the optimal management of this population remains largely unsettled because older patients are often excluded from clinical trials. However, the classic nihilistic approach is progressively changing towards more active strategies. Particularly, prospective randomized studies have recently established the benefit of radiation therapy and the validity of an accelerated course of radiation in older patients suffering from malignant gliomas. The interest of chemotherapy, alone or concomitant with radiation therapy is still under evaluation in this population. Initial performance status, quality of life and concomitant pathologies are important factors to consider before treatment onset. In the future, it will be necessary to develop specific schedules of treatment in this population.