dc.description.abstract | Biologically younger, fully independent octogenarians are able to tolerate most
oncological treatments. Increasing frailty results in decreasing eligibility for
certain treatments, e.g., chemotherapy and surgery. Most brain metastases are
not an isolated problem, but part of widespread cancer dissemination, often in
combination with compromised performance status. Multidisciplinary
assessment is key in this vulnerable patient population where age, frailty,
comorbidity and even moderate additional deficits from brain metastases or
their treatment may result in immobilization, hospitalization, need for nursing
home care, termination of systemic anticancer treatment etc. Here, we provide
examples of successful treatment (surgery, radiosurgery, systemic therapy) and
best supportive care, and comment on the limitations of prognostic scores,
which often were developed in all-comers rather than octogenarians. Despite
selection bias in retrospective studies, survival after radiosurgery was more
encouraging than after whole-brain radiotherapy. Prospective research with
focus on octogenarians is warranted to optimize outcomes. | en_US |