TREATMENTS FOR GLIOBLASTOMA MULTIFORME (GBM)

Standard treatment includes resection, followed by concurrent chemotherapy and radiotherapy.

Newly diagnosed tumors (Glioblastomas (WHO grade IV))

Maximal surgical resection, plus radiotherapy, plus concomitant and adjuvant TMZ or carmustine wafers   (Gliadel). 

-Surgical resection: Surgical debulking reduces the symptoms from mass effect and provides tissue for histologic diagnosis and molecular studies. Malignant gliomas cannot be completely removed surgically because of their infiltrative nature, but patients should undergo maximal surgical resection whenever possible

-Radiotherapy: Conventional radiotherapy usually consists of 60 Gy of partial-field external-beam irradiation delivered 5 days per week in fractions of 1.8 to 2.0 Gy.

Recurrent tumors

Reoperation in selected patients, carmustine wafers (Gliadel), conventional chemotherapy (e.g., lomustine, carmustine, PCV, carboplatin, irinotecan, etoposide), bevacizumab plus irinotecan, experimental therapies

Selected References:  Olson et al, 2009 - Kanu et al, 2009 - Wen and Kesari, 2008 - Stupp et al, 2005