Abstract
The incidence of glioblastoma (GBM) peaks in the 7th and 8th decades of life. Multiple treatment options exist for older patients with GBM however, the assessment of older patients prior to treatment decisions is poorly researched and lacks standardization. In order to address this issue we performed a cross-sectional electronic survey distributed to all full members of the Society for Neuro-Oncology. There were 116 respondents from a total of 1515 recipients (8% response rate). The survey was distributed during the peak of COVID-19 which undoubtedly affected response rates. 97% of respondents were clinicians with 86% academic. 72% had been in practice > 10 years and the majority saw 5–10 new GBM cases per month. 95% of respondents were from the USA, with involvement from Japan, Australia, Canada and Italy. 37% of respondents routinely perform a cognitive or frailty screening test. Of these, MMSE and MoCA were the most commonly used. Of those who performed a screening test, the majority reported that the results changed their treatment decision in approximately 50% of cases. 50% of respondents have access to a multidisciplinary team during their clinic, with physical therapy being the most available. When making treatment decisions, participants ranked performance status as the most important clinical factor. Considering the heterogeneity of this patient population, we argue that performance status is a crude measure of vulnerability within this cohort. In the first survey of this kind, we have shown a disparity in assessment techniques across the international neuro-oncology field and the impact performing a cognitive screen has on decision making. Older patients with GBM represent a unique clinical scenario because of the complexity of distinguishing neuro- oncology related symptoms from general frailty. There is a need for specific geriatric assessment models tailored to the older neuro-oncology population in order to facilitate treatment decisions.
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