Glioblastoma (also called glioblastoma multiforme –GBM) is a primary brain neoplasm, representing about 55% of all gliomas. It is a very aggressive and infiltrative tumor. Glioblastoma is usually highly malignant, with more than 90% 5-year mortality and a median survival of about 14.6 months. Compared to other cancers, the survival rate has not greatly changed over time and no current treatment is curative for this disease. Because the tumor has a heterogeneous cell population containing several types of cells, the treatment for GBM is one of the most challenging in clinical oncology. This chapter will discuss the current approaches in glioblastoma treatment, including resection techniques, chemotherapy and radiation therapy.

GBMs are typically large tumors at diagnosis. They occur most commonly in the supratentorial compartment and are less common in the posterior fossa and brainstem. Lesions usually start within the deep white matter, but often infiltrate into cortex, deep nuclei or through commissural pathways into the contralateral hemisphere.

Effective treatment in GBM remains one of the most formidable challenges in neuro-oncology. Treatment is multimodal and despite significant advances in diagnostic technology, surgical technique, radiation, chemotherapy and targeted therapy, the prognosis remains poor. Large-scale research efforts are required to understand the molecular biology of brain tumors and to discover novel therapies. Synergistic multimodal strategies and individualized treatments are likely to be the best approach of these complex tumors to finally improve survival and quality of life of the patients.

Research

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