Multidisciplinary Treatment for Glioblastoma

Abstract

  Glioblastoma is the most malignant brain tumor, with a median survival of approximately. two years. Glioblastoma treatment can be broadly divided into three categories : surgery, radiation therapy, and chemotherapy. Removal beyond the contrast-enhanced site has been reported to be better because the removal rate is a prognostic factor. However, it is necessary to emphasize the functional prognosis. Therefore, in addition to conventional intraoperative monitoring, intraoperative fluorescence diagnosis using 5-ALA, awake surgery, and intraoperative magnetic resonance imaging are performed. As intraoperative local therapy, carmustine wafer placement and photodynamic therapy are also performed at the excised part. In addition, temozolomide and bevacizumab are used for chemotherapy, but the optimal timing and method of administration of bevacizumab are still debated. For radiation therapy, short-term irradiation is recommended for elderly patients. In addition, electric field therapy with a novo-TTF device is a new treatment method that suppresses cell division by the force of the electric field. In addition, various treatments including immunotherapy and viral therapy have been devised for the treatment of glioblastoma. This article outlines the findings to help to understand the latest glioma multidisciplinary treatments.