Initial Treatment of IDH-Wildtype Glioblastoma in Adults Older Than 70 Years

Abstract

The incidence of glioblastoma, the most common malignant primary brain tumour in adults, increases after the age of 40 and peaks in adults aged 75-84 years. Initial management involves maximising surgical resection while preserving neurologic function. IDH mutations and MGMT promoter methylation should be checked in tumour samples. Radiation and temozolomide constitute initial treatment for newly diagnosed glioblastoma patients with good functional status. It is suggested that patients who have received concurrent and adjuvant temozolomide treatment should undergo six cycles of adjuvant monthly temozolomide, as opposed to a more extended treatment regimen. Low-intensity alternating electric field therapy improved survival in a large randomised trial. We provide a detailed review, providing the latest treatment viewpoint for IDH -wildtype glioblastoma and including the current situation of immunotherapy. The treatment ideas and methods reviewed here would be of help to physicians when they encounter patients with this kind of IDH -wildtype glioblastoma in clinical practice.