Glioblastoma radiation therapy combined with temozolomide doubles survival

  Glioblastomas and malignant gliomas are the most common primary malignant brain tumors, with an annual incidence of approximately 5.26 cases per 100,000 people and 17,000 new patients diagnosed each year. These tumors are typically associated with poor prognosis and poor quality of life for patients. Recently, Dr. ntonio Omuro of the Sloan-Kettering Cancer Institute in New York City, USA, published a recent review in the JAMA journal in this area.  The study was designed to provide an overview of the clinical management of malignant glioma, including genetic risk factors and environmental risk factors such as cell phone use, diagnostic deficits, symptom management, specific antitumor therapy, and common complications. The investigators searched the PubMed database from January 2000 to May 2013 for the keywords glioblastoma, glioma, malignant glioma, pleomorphic glioblastoma, primitive oligodendroglioma, mesenchymal oligodendroglioma – astrocytoma, and brain tumors. The investigators also tracked the findings of a series of authors in the literature. The evidence was graded using the American Heart Association classification system.  The results found that radiation exposure and specific genetic syndromes were the only clear risk factors for malignant glioma. Treatment of newly diagnosed glioblastoma was based on radiotherapy combined with temozolomide. This clinical pathway has multiplied the 2-year survival rate to 27%, however the overall prognosis remains poor. Bevacizumab is an emerging alternative that deserves further investigation. class III oncology studies are scarce and clinical trials exploring its standard of care are underway. Patients with malignant gliomas often have frequent complications, including thrombotic events, seizures, recurrent neurologic symptoms, and other adverse effects from corticosteroids and chemotherapy, which need to be managed and prevented effectively.  The study concluded that although treatment options for glioblastoma have improved, it is still a difficult cancer to treat. Optimal treatment options may require a multidisciplinary approach and a better understanding of the disease itself and the potential complications arising from treatment.