Glioblastoma

Glioblastoma
Other namesGlioblastoma multiforme
Coronal MRI (viewed from the back of the head) with contrast of a glioblastoma in a 15-year-old male
SpecialtyNeuro-oncology, neurosurgery
SymptomsInitially nonspecific, headaches, personality changes, nausea, symptoms similar to a stroke[1]
Usual onset~64 years old[2][3]
CausesUsually unclear[2]
Risk factorsGenetic disorders (neurofibromatosis, Li–Fraumeni syndrome), previous radiation therapy[2][3]
Diagnostic methodCT scan, MRI scan, tissue biopsy[1]
PreventionUnknown[3]
TreatmentSurgery, chemotherapy, radiation[3]
MedicationTemozolomide, steroids[1][4]
PrognosisLife expectancy ~ 12 months with treatment (5 year survival <10%)[2][5]
Frequency3 per 100,000 per year[3]

Glioblastoma, previously known as glioblastoma multiforme (GBM), is the most aggressive and most common type of cancer that originates in the brain, and has a very poor prognosis for survival.[6][7][8] Initial signs and symptoms of glioblastoma are nonspecific.[1] They may include headaches, personality changes, nausea, and symptoms similar to those of a stroke.[1] Symptoms often worsen rapidly and may progress to unconsciousness.[2]

The cause of most cases of glioblastoma is not known.[2] Uncommon risk factors include genetic disorders, such as neurofibromatosis and Li–Fraumeni syndrome, and previous radiation therapy.[2][3] Glioblastomas represent 15% of all brain tumors.[1] They are thought to arise from astrocytes.[9] The diagnosis typically is made by a combination of a CT scan, MRI scan, and tissue biopsy.[1]

There is no known method of preventing the cancer.[3] Treatment usually involves surgery, after which chemotherapy and radiation therapy are used.[3] The medication temozolomide is frequently used as part of chemotherapy.[3][4][10] High-dose steroids may be used to help reduce swelling and decrease symptoms.[1] Surgical removal (decompression) of the tumor is linked to increased survival, but only by some months.[11]

Despite maximum treatment, the cancer almost always recurs.[3] The typical duration of survival following diagnosis is 10–13 months, with fewer than 5–10% of people surviving longer than five years.[12][13][5] Without treatment, survival is typically three months.[14] It is the most common cancer that begins within the brain and the second-most common brain tumor, after meningioma, which is benign in most cases.[6][15] About 3 in 100,000 people develop the disease per year.[3] The average age at diagnosis is 64, and the disease occurs more commonly in males than females.[2][3]

Tumors of the central nervous system are the 10th leading cause of death worldwide, with up to 90% being brain tumors.[16] Glioblastoma multiforme (GBM) is derived from astrocytes and accounts for 49% of all malignant central nervous system tumors, making it the most common form of central nervous system cancer. Despite countless efforts to develop new therapies for GBM over the years, the median survival rate of GBM patients worldwide is 8 months; radiation and chemotherapy standard-of-care treatment beginning shortly after diagnosis improve the median survival length to around 14 months and a five-year survival rate of 5–10%. The five-year survival rate for individuals with any form of primary malignant brain tumor is 20%.[17] Even when all detectable traces of the tumor are removed through surgery, most patients with GBM experience recurrence of their cancer.

  1. ^ a b c d e f g h Young RM, Jamshidi A, Davis G, Sherman JH (June 2015). "Current trends in the surgical management and treatment of adult glioblastoma". Annals of Translational Medicine. 3 (9): 121. doi:10.3978/j.issn.2305-5839.2015.05.10. PMC 4481356. PMID 26207249.
  2. ^ a b c d e f g h "Chapter 5.16". World Cancer Report 2014. World Health Organization. 2014. ISBN 978-92-832-0429-9.
  3. ^ a b c d e f g h i j k l Gallego O (August 2015). "Nonsurgical treatment of recurrent glioblastoma". Current Oncology. 22 (4): e273–e281. doi:10.3747/co.22.2436. PMC 4530825. PMID 26300678.
  4. ^ a b Hart MG, Garside R, Rogers G, Stein K, Grant R (April 2013). "Temozolomide for high grade glioma". The Cochrane Database of Systematic Reviews. 2013 (4): CD007415. doi:10.1002/14651858.CD007415.pub2. PMC 6457743. PMID 23633341.
  5. ^ a b Ostrom QT, Cioffi G, Gittleman H, Patil N, Waite K, Kruchko C, et al. (November 2019). "CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2012–2016". Neuro-Oncology. 21 (Suppl 5): v1–v100. doi:10.1093/neuonc/noz150. PMC 6823730. PMID 31675094.
  6. ^ a b Bleeker FE, Molenaar RJ, Leenstra S (May 2012). "Recent advances in the molecular understanding of glioblastoma". Journal of Neuro-Oncology. 108 (1): 11–27. doi:10.1007/s11060-011-0793-0. PMC 3337398. PMID 22270850.
  7. ^ Tan AC, Ashley DM, López GY, Malinzak M, Friedman HS, Khasraw M (July 2020). "Management of glioblastoma: State of the art and future directions". CA. 70 (4). Wiley: 299–312. doi:10.3322/caac.21613. hdl:10536/DRO/DU:30138185. PMID 32478924. S2CID 219170898.
  8. ^ Tran B, Rosenthal MA (April 2010). "Survival comparison between glioblastoma multiforme and other incurable cancers". Journal of Clinical Neuroscience. 17 (4): 417–421. doi:10.1016/j.jocn.2009.09.004. PMID 20167494. S2CID 5492993.
  9. ^ "Chapter 3.8". World Cancer Report 2014. World Health Organization. 2014. ISBN 978-92-832-0429-9.
  10. ^ Cite error: The named reference RTG1 was invoked but never defined (see the help page).
  11. ^ Van Meir EG, Hadjipanayis CG, Norden AD, Shu HK, Wen PY, Olson JJ (2010). "Exciting new advances in neuro-oncology: the avenue to a cure for malignant glioma". CA. 60 (3): 166–193. doi:10.3322/caac.20069. PMC 2888474. PMID 20445000.
  12. ^ McKenney AS, Weg E, Bale TA, Wild AT, Um H, Fox MJ, et al. (6 February 2022). "Radiomic Analysis to Predict Histopathologically Confirmed Pseudoprogression in Glioblastoma Patients". Advances in Radiation Oncology. 8 (1): 100916. doi:10.1016/j.adro.2022.100916. PMC 9873493. PMID 36711062. S2CID 246647975.
  13. ^ Stupp R, Hegi ME, Mason WP, van den Bent MJ, Taphoorn MJ, Janzer RC, et al. (May 2009). "Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trial". The Lancet. Oncology. 10 (5): 459–466. doi:10.1016/S1470-2045(09)70025-7. PMID 19269895. S2CID 25150249.
  14. ^ Schapira AH (2007). Neurology and clinical neuroscience. Philadelphia: Mosby Elsevier. p. 1336. ISBN 978-0-323-07053-9. Archived from the original on 29 July 2017.
  15. ^ McNeill KA (November 2016). "Epidemiology of Brain Tumors". Neurologic Clinics. 34 (4): 981–998. doi:10.1016/j.ncl.2016.06.014. PMID 27720005.
  16. ^ Ostrom QT, Patil N, Cioffi G, Waite K, Kruchko C, Barnholtz-Sloan JS (October 2020). "CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2013–2017". Neuro-Oncology. 22 (12 Suppl 2): iv1–iv96. doi:10.1093/neuonc/noaa200. PMC 7596247. PMID 33123732.
  17. ^ Visser O, Ardanaz E, Botta L, Sant M, Tavilla A, Minicozzi P (October 2015). "Survival of adults with primary malignant brain tumours in Europe; Results of the EUROCARE-5 study". European Journal of Cancer. 51 (15): 2231–2241. doi:10.1016/j.ejca.2015.07.032. PMID 26421825.