NQPC-18 THERAPEUTIC STRATEGY FOCUSING ON COGNITIVE FUNCTION AND QOL IN ELDERLY PATIENTS WITH MALIGNANT BRAIN TUMORS

BACKGROUND: Standard treatments for malignant brain tumors, such as glioblastoma (GBM) and primary CNS lymphoma (PCNSL), are recently established, except for elderly patients with neuro-cognitive impairment. We investigated our experience to adjust possible therapeutic strategy for malignant brain tumors in elderly patients according to cognitive function and QOL. METHODS: We utilized medical record data from 2015 to 2022 in our facility. Fourteen patients (11 patients with GBM and 3 with PCNSL) were retrospectively analyzed for performance status before and after surgery, neuro-cognitive function, treatments, and survival data. RESULTS: Median age was 76 years old, median preoperative Karnofsky performance status (KPS) was 70, median postoperative KPS was 60, and median score of mini mental state examination (MMSE) was 18/30. Several patients with GBM deteriorated on the MMSE score and KPS after surgery, and the individuals who scored < 10 on the MMSE avoided radiation thrapy, while two patients with PCNSL improved on the MMSE score and KPS. Three patients with GBM and two patients with PCNSL received standard therapies. The rest of patients received alternative therapies; three patients had medical problems for receiving standard treatment, three patients avoided radiation therapy due to cognitive impairment, and three patients declined standard treatment. Median overall survival time in GBM patients was 254 days, and two patients with PCNSL have been still alive. CONCLUSIONS: Treatments for malignant brain tumors in elderly patients are difficult, because of their comorbidities, shorter life expectancy, and cognitive impairment. On the other hand, anticancer drug therapy alone is sometimes effective and prolongs survival of those patients. Development of personalized treatment is needed focusing on cognitive function and QOL in elderly brain tumor patients.