Glioblastoma multiforme medical therapy: Difference between revisions
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==Overview== | ==Overview== | ||
The predominant therapy for glioblastoma is [[surgical resection]]. Adjunctive [[chemotherapy]] and [[radiation]] may be required.<ref name=ddd>Treatment of glioblastoma multiforme. Dr Dylan Kurda and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/glioblastoma</ref> Supportive therapy for glioblastoma includes [[anticonvulsants]] and [[corticosteroids]]. | The predominant therapy for glioblastoma multiforme is [[surgical resection]]. Adjunctive [[chemotherapy]] and [[radiation]] may be required.<ref name=ddd>Treatment of glioblastoma multiforme. Dr Dylan Kurda and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/glioblastoma</ref> Supportive therapy for glioblastoma multiforme includes [[anticonvulsants]] and [[corticosteroids]]. | ||
==Medical Therapy== | ==Medical Therapy== | ||
The predominant therapy for glioblastoma is [[surgical resection]]. Adjunctive [[chemotherapy]] and [[radiation]] may be required.<ref name=ddd>Treatment of glioblastoma multiforme. Dr Dylan Kurda and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/glioblastoma</ref> | The predominant therapy for glioblastoma multiforme is [[surgical resection]]. Adjunctive [[chemotherapy]] and [[radiation]] may be required.<ref name=ddd>Treatment of glioblastoma multiforme. Dr Dylan Kurda and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/glioblastoma</ref> | ||
===Supportive treatment=== | ===Supportive treatment=== | ||
Supportive therapy for glioblastoma includes [[anticonvulsants]] and [[corticosteroids]], which focuses on relieving symptoms and improving the patient’s neurologic function. | Supportive therapy for glioblastoma multiforme includes [[anticonvulsants]] and [[corticosteroids]], which focuses on relieving symptoms and improving the patient’s neurologic function. | ||
*[[Anticonvulsants]] are administered to the patients who have a [[seizure]]. [[Phenytoin]] given concurrently with [[radiation]] may have serious skin reactions such as [[erythema multiforme]] and [[Stevens-Johnson syndrome]]. | *[[Anticonvulsants]] are administered to the patients who have a [[seizure]]. [[Phenytoin]] given concurrently with [[radiation]] may have serious skin reactions such as [[erythema multiforme]] and [[Stevens-Johnson syndrome]]. | ||
*[[Corticosteroids]], usually [[dexamethasone]] given 4-10 mg every 4-6 h, can reduce peritumoral [[edema]], diminish mass effect, and lower [[intracranial pressure]] with a decrease in [[headache]] or [[drowsiness]]. | *[[Corticosteroids]], usually [[dexamethasone]] given 4-10 mg every 4-6 h, can reduce peritumoral [[edema]], diminish mass effect, and lower [[intracranial pressure]] with a decrease in [[headache]] or [[drowsiness]]. | ||
===Radiotherapy=== | ===Radiotherapy=== | ||
*After [[surgery]], [[radiotherapy]] is recommended among all patients who develop glioblastoma. | *After [[surgery]], [[radiotherapy]] is recommended among all patients who develop glioblastoma multiforme. | ||
*Adjuvant radiotherapy can reduce the [[tumor]] size to 10<sup>7</sup> cells. | *Adjuvant radiotherapy can reduce the [[tumor]] size to 10<sup>7</sup> cells. | ||
*Radiotherapy may not cure the cancer, but can control the tumor and delay recurrence. | *Radiotherapy may not cure the cancer, but can control the tumor and delay recurrence. | ||
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===Chemotherapy=== | ===Chemotherapy=== | ||
*[[Chemotherapy]] is indicated as adjuvant therapy for glioblastoma. | *[[Chemotherapy]] is indicated as adjuvant therapy for glioblastoma multiforme. | ||
*[[Temozolomide]] ([[Temodar]]) is the preferred drug for the treatment of glioblastoma. | *[[Temozolomide]] ([[Temodar]]) is the preferred drug for the treatment of glioblastoma multiforme. | ||
*Other chemotherapeutic drugs that may be used for the treatment of glioblastoma include: | *Other chemotherapeutic drugs that may be used for the treatment of glioblastoma multiforme include: | ||
**[[Carmustine]] | **[[Carmustine]] | ||
**[[Lomustine]] | **[[Lomustine]] | ||
Revision as of 18:02, 18 September 2015
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
The predominant therapy for glioblastoma multiforme is surgical resection. Adjunctive chemotherapy and radiation may be required.[1] Supportive therapy for glioblastoma multiforme includes anticonvulsants and corticosteroids.
Medical Therapy
The predominant therapy for glioblastoma multiforme is surgical resection. Adjunctive chemotherapy and radiation may be required.[1]
Supportive treatment
Supportive therapy for glioblastoma multiforme includes anticonvulsants and corticosteroids, which focuses on relieving symptoms and improving the patient’s neurologic function.
- Anticonvulsants are administered to the patients who have a seizure. Phenytoin given concurrently with radiation may have serious skin reactions such as erythema multiforme and Stevens-Johnson syndrome.
- Corticosteroids, usually dexamethasone given 4-10 mg every 4-6 h, can reduce peritumoral edema, diminish mass effect, and lower intracranial pressure with a decrease in headache or drowsiness.
Radiotherapy
- After surgery, radiotherapy is recommended among all patients who develop glioblastoma multiforme.
- Adjuvant radiotherapy can reduce the tumor size to 107 cells.
- Radiotherapy may not cure the cancer, but can control the tumor and delay recurrence.
- Targeted three-dimensional conformal radiotherapy is preferred to whole brain radiotherapy.
- Total radiation dose of 60–65 Gy has been found to be optimal for treatment.
Chemotherapy
- Chemotherapy is indicated as adjuvant therapy for glioblastoma multiforme.
- Temozolomide (Temodar) is the preferred drug for the treatment of glioblastoma multiforme.
- Other chemotherapeutic drugs that may be used for the treatment of glioblastoma multiforme include:
References
- ↑ 1.0 1.1 Treatment of glioblastoma multiforme. Dr Dylan Kurda and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/glioblastoma