Purpose of review: This review updates available data on the management of gliomas in the elderly.
Recent findings: Prospective randomized studies have recently established the benefit of radiotherapy and the validity of an accelerated course of irradiation in older patients with malignant gliomas.
Summary: The incidence of gliomas is increasing in the elderly population. Unfortunately, increasing age is one of the most consistent negative prognostic factors in gliomas and the optimal management of this population remains unsettled since patients aged 65 years or more are usually excluded from clinical trials. The previous nihilistic approach is progressively changing towards more active strategies with recent evidence that older patients (70-80 years) may benefit from surgery, radiotherapy, or chemotherapy. Initial performance status, quality of life, and concomitant pathologies are important factors to consider before treatment onset. In the future, it will be necessary to design specific schedules of treatment in this population.