Glioblastoma Multiforme

Radiologic-Pathologic Correlation

Abstract Introduction Clinical Presentation Historical Perspective

Etiology and Genetics Pathologic Characteristics Radiologic-Pathologic Correlation

Therapy and Prognosis Conclusions Source Information References

Therapy and Prognosis

Initial treatment of GBM involves surgical resection and debulking of the tumor to whatever extent possible, based on the location and extent of the tumor at the time of initial diagnosis. Surgery is usually followed by radiation therapy and, depending on clinical circumstances, various forms of chemotherapy. Radiation treatment may be administered as whole-brain irradiation, focused beam (with a gamma knife or particle bombardment where available) therapy, or brachytherapy. Chemotherapeutic response is optimized with use of multiple drug combinations, although some single-drug regimens are nearly as effective (39).

Despite the best efforts of neurosurgeons, neuro-oncologists, and radiation therapists, complete cure of GBM is rare, and the average life span of the patient who undergoes treatment with surgery, radiation, and chemotherapy from time of diagnosis is estimated at 16-18 months (42). Without therapy, average survival is 6 months, which is roughly comparable with estimates of survival for patients who underwent therapy 50 years ago.

Limited clinical trials of adjunctive gene therapy have been performed; in these trials, antigenic viral particles (primarily herpes simplex virus type 1) are inserted into neoplastic tissue in attempt to induce a host immune response against the tumor (43). These attempts have met with some limited success, as has the use of interleukin therapy to activate killer T cells and thereby increase the role of cell-mediated immunity in the host (44). As mentioned, various trials involving the p53 gene are under way, and further investigations of other tumor-suppressor agents are planned. Whether these initial attempts are successful or not, the possibility of future uses of the information gained from the study of the genetic basis of neoplastic transformation represents an exciting area of scientific advancement.

Abstract Introduction Clinical Presentation Historical Perspective

Etiology and Genetics Pathologic Characteristics Radiologic-Pathologic Correlation

Therapy and Prognosis Conclusions Source Information References