Glioblastoma: Difference between revisions
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It is termed "malignant", which usually refers to the propensity to [[metastasis|metastasize]], but, as typical of central nervous system [[neoplasia|neoplasms]], does not metastasize beyond the [[blood-brain barrier]] but expands rapidly within the central nervous system. GBM is the most common and aggressive primary (i.e., not from metastasis) brain tumor. | It is termed "malignant", which usually refers to the propensity to [[metastasis|metastasize]], but, as typical of central nervous system [[neoplasia|neoplasms]], does not metastasize beyond the [[blood-brain barrier]] but expands rapidly within the central nervous system. GBM is the most common and aggressive primary (i.e., not from metastasis) brain tumor. | ||
There has been an overall increase in diagnoses of gliomas in the United States, but it is argued variously that there is a true increase, or that they are being diagnosed more often due to the revised classification or better [[medical imaging]].<ref>{{citation | |||
| Adult glioma incidence trends in the United States, 1977-2000 (abstract) | |||
| journal = Cancer | |||
| year = 2004 | volume = 101| issue = 10 |pages =2293-9 | |||
| author = Hess KR; Broglio KR; Bondy ML | |||
==Diagnosis== | ==Diagnosis== | ||
===Symptoms=== | ===History and physical=== | ||
Symptoms are nonspecific, including headache, seizures, cognitive changes and focal neurologic signs. | |||
===Imaging=== | |||
[[Magnetic resonance imaging]] is the preferred study. GBMs characteristically have low-signal intensity on T1-weighted images and high-signal intensity on T2-weighted images. With contrast, T1-weighted images typically have a central hypodensity surrounded by a thick enhancing rim of tumor. | |||
===Histopathology=== | ===Histopathology=== | ||
It is a more [[pleomorphism|pleomorphic]] and faster-growing form of [[astrocytoma]], and is also called Grade IV astrocytoma. In addition to pleomorphism, the histopathology includes nuclear atypia, microhemorrhage, and necrosis. Margins are irregular and it is not encapsulated. | It is a more [[pleomorphism|pleomorphic]] and faster-growing form of [[astrocytoma]], and is also called Grade IV astrocytoma. In addition to pleomorphism, the histopathology includes nuclear atypia, microhemorrhage, and necrosis. Margins are irregular and it is not encapsulated. | ||
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Techniques of radiation therapy continue to evolve. The standard of care is fractionated electron beam radiotherapy, but methods being investigated include [[brachytherapy]] with implanted <sub>131</sub>[[iodine]] seeds, <ref name=eMed-Treat>{{citation | Techniques of radiation therapy continue to evolve. The standard of care is fractionated electron beam radiotherapy, but methods being investigated include [[brachytherapy]] with implanted <sub>131</sub>[[iodine]] seeds, <ref name=eMed-Treat>{{citation | ||
| Glioblastoma Multiforme: Treatment & Medication | | title = Glioblastoma Multiforme: Treatment & Medication | ||
| author = Salah Uddin and Tambi Jarmi | | author = Salah Uddin and Tambi Jarmi | ||
| journal = eMedicine | | journal = eMedicine | ||
Revision as of 15:27, 18 June 2010
A glioblastoma or glioblastoma multiforme (GBM) is a highly invasive tumor of the central nervous system, primarily of the brain, and, more specifically, the cerebral hemispheres, basal ganglia, and commissural pathways.[1] It is not curable with present methods, although recent developments have improved median survival. Onset is most common in the fifth or sixth decade of life, but certainly can appear in any adult or adolescent stage.
It is termed "malignant", which usually refers to the propensity to metastasize, but, as typical of central nervous system neoplasms, does not metastasize beyond the blood-brain barrier but expands rapidly within the central nervous system. GBM is the most common and aggressive primary (i.e., not from metastasis) brain tumor.
There has been an overall increase in diagnoses of gliomas in the United States, but it is argued variously that there is a true increase, or that they are being diagnosed more often due to the revised classification or better medical imaging.Cite error: Closing </ref> missing for <ref> tag
While the preferred chemotherapeutic agent is temozolomide, ongoing studies also show a value for BCNU. One study with temozolomide and radiation showed median survival of 14.6 months with radiation therapy plus temozolomide and 12.1 months with radiation therapy alone.[2] Some temozolomide-treated patients have survived for 5 years.
References
- ↑ Anonymous (2024), Glioblastoma (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ R. Stupp, M. Hegi, W. Mason, M. van den Bent, M. Taphoorn, R. Janzer, S. Ludwin, A. Allgeier, B. Fisher, K. Belanger, "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)