CNS tumors in older adults

Abstract

Primary tumors of the central nervous system (CNS) comprise a broad variety of neoplasms with specific patterns of age distribution, pathological and molecular genetic features, and outcome. Major recent advances in understanding the molecular pathogenesis of many primary CNS tumors have resulted in a revision of the World Health Organization (WHO) classification of brain tumors in 2016. Secondary CNS tumors are represented by brain and leptomeningeal metastases and are more common than primary CNS tumors. The most common primary CNS tumors, glioblastomas and meningiomas, are particularly common in the elderly. Notably glioblastomas in the elderly carry a very poor prognosis. Similarly, secondary CNS tumors are common in the elderly since they reflect the increasing risk of systemic cancer with advanced age. Multimodality treatment with its increasing complexity regarding drug interactions and comorbidity-associated risk of toxicity poses specific challenges in the elderly.