Primary Central Nervous System Tumors in the Aging Population

The incidence of primary brain tumors peaks in the aging population, and advanced age in often a prognostic factor associated with shorter survival. In the United States, it is estimated that 69,720 individuals will be diagnosed with primary CNS tumors in 2013, of which 24,560 are expected to be malignant and 45,160 non-malignant. Approximately 50 % of primary CNS tumors are expected to occur in individuals who are 65 years or older. Management of elderly patients with primary brain tumors is challenging because there is no accepted standard of care treatment and this population may have multiple comorbidities, decreased tolerance to treatment, and increased risk for radiation-induced neurotoxicity. This review gives an overview of the treatment options for older patients with glioblastoma and meningioma, the most common primary brain tumors in this population. Treatment of elderly patients with primary brain tumors needs to be individualized, and old age alone should not preclude the use of life-prolonging treatments.