Glioblastoma multiforme medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Marjan Khan M.B.B.S.[2]
Overview
The predominant therapy for glioblastoma multiforme is surgical resection. Adjunctive chemotherapy and radiation may be required.[1][2][3] Supportive therapy for glioblastoma multiforme includes anticonvulsants and corticosteroids.Cytotoxic therapy for GBM has evolved due to the approval of temozolomide,an alkylating agent- for newly diagnosed GBM. Active agents include also the nitrosureas which include carmustine and lomustine, platinum agents, etoposide, irinotecan and PCV combination.
Medical Therapy
The predominant therapy for glioblastoma multiforme is surgical resection. Adjunctive chemotherapy and radiation may be required.[1][2][3]
Radiotherapy
- Post-operative 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 5,000-6,000 cGy has been found to be optimal for treatment.[2]
Chemotherapy
- Chemotherapy is indicated as adjuvant therapy for glioblastoma multiforme.[3]
- Temozolomide (Temodar) is the preferred drug for the treatment of glioblastoma multiforme.[3]
- Other chemotherapeutic drugs that may be used for the treatment of glioblastoma multiforme include:
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.
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
- ↑ 2.0 2.1 2.2 Barani IJ, Larson DA (2015). "Radiation therapy of glioblastoma". Cancer Treat Res. 163: 49–73. doi:10.1007/978-3-319-12048-5_4. PMID 25468225.
- ↑ 3.0 3.1 3.2 3.3 Minniti G, Muni R, Lanzetta G, Marchetti P, Enrici RM (2009). "Chemotherapy for glioblastoma: current treatment and future perspectives for cytotoxic and targeted agents". Anticancer Res. 29 (12): 5171–84. PMID 20044633.