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Management of brain metastases in elderly patients with lung cancer
- Source :
- J Thorac Dis
- Publication Year :
- 2021
- Publisher :
- AME Publishing Company, 2021.
-
Abstract
- The incidence of brain metastases (BM) is continuing to grow in the elderly population with lung cancer, but these patients are seriously under-represented in clinical trials. Thus, their treatment is not based on the evidence from randomized prospective studies. Age is a well recognized poor prognostic factor for survival in patients with BM from lung cancer, which is reflected in prognostic scales, but its impact on the patients' prognosis reflected by its value in gradually updated grading indices seems to decrease. The reason for poorer outcomes in the elderly is unknown-it may result from the influence of the age per se, simplified staging work-up and suboptimal treatment in this patient subgroup or the excess toxicity of the aggressive anticancer treatment secondary to the impaired physiological regulation mechanisms and comorbidities. The main goal of treatment of BM is to ameliorate neurological symptoms and delay neurological progression, with the focus on the improvement and maintenance of the patients' quality of life. The possible treatment options for BM from lung cancer are whole-brain radiotherapy, stereotactic radiosurgery, surgery, chemotherapy, targeted therapies and best supportive care. The aim of this review is to summarize the problems related to the management of BM in elderly patients with lung cancer, to analyze the value of the above mentioned treatment options, and to provide an insight into the influence of age-related clinical factors on the patients' outcomes.
- Subjects :
- Pulmonary and Respiratory Medicine
Oncology
medicine.medical_specialty
Chemotherapy
business.industry
medicine.medical_treatment
medicine.disease
Radiosurgery
Radiation therapy
Clinical trial
03 medical and health sciences
0302 clinical medicine
Quality of life
Review Article on Radiotherapy for Brain Metastases from Lung Cancer
030220 oncology & carcinogenesis
Internal medicine
medicine
Lung cancer
business
Prospective cohort study
Grading (tumors)
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 20776624 and 20721439
- Volume :
- 13
- Database :
- OpenAIRE
- Journal :
- Journal of Thoracic Disease
- Accession number :
- edsair.doi.dedup.....f7a4d8827cf06c4672424a683b63275a
- Full Text :
- https://doi.org/10.21037/jtd-2019-rbmlc-05