Adult Brain Tumor Treatment Information for Physicians

Important: This information is intended mainly for use by doctors and other health care professionals. If you have questions about this topic, you can ask your doctor, or call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237).

ADULT GLIOBLASTOMA MULTIFORME

For glioblastoma multiforme, the cure rate is very low with standard local treatment. These patients are appropriate candidates for clinical trials designed to improve local control by adding newer forms of treatment to standard treatment.

Treatment options:

Standard:

1. Surgery plus radiation therapy and chemotherapy.[1,2]

2. Surgery plus radiation therapy.

Patients with brain tumors that are either infrequently curable or
unresectable should be considered candidates for clinical trials that
evaluate hyperfractionated irradiation, accelerated fraction irradiation,
stereotactic radiosurgery, radiosensitizers, hyperthermia, interstitial
brachytherapy, or intraoperative radiation therapy used in conjunction with external-beam radiation therapy to improve local control of the tumor and/or for studies that evaluate new drugs and biological response modifiers following radiation therapy.[3-6] Cooperative group studies that evaluate hyperfractionated irradiation and interstitial brachytherapy are in progress.[7]Carmustine (BCNU) impregnated polymer may be implanted during surgery.[8,9]

1. Shapiro WR: Therapy of adult malignant brain tumors: what have the clinical trials taught us? Seminars in Oncology 13(1): 38-45, 1986.
2. Rodriguez L, Levin V: Does chemotherapy benefit the patient with a central nervous system glioma? Oncology (Huntington NY) 1(9): 29-36, 1987.
3. Leibel SA, Gutin PH, Sneed PK, et al.: Interstitial irradiation for the treatment of primary and metastatic brain tumors. Cancer: Principles and Practice of Oncology Updates 3(7): 1-11, 1989.
4. Nelson DF, Urtasun RC, Saunders WM, et al.: Recent and current investigations of radiation therapy of malignant gliomas. Seminars in Oncology 13(1): 46-55, 1986.
5. Loeffler JS, Alexander E, Shea WM, et al.: Radiosurgery as part of the initial management of patients with malignant gliomas. Journal of Clinical Oncology 10(9): 1379-1385, 1992.
6. Fontanesi J, Clark WC, Weir A, et al.: Interstitial iodine 125 and concomitant cisplatin followed by hyperfractionated external beam irradiation for malignant supratentorial glioma. American Journal of Clinical Oncology 16(5): 412-417, 1993.
7. Scharfen CO, Sneed PK, Wara WM, et al.: High activity iodine-125 interstitial implant for gliomas. International Journal of Radiation Oncology, Biology, Physics 24(1): 583-591, 1992.
8. Brem H, Piantadosi S, Burger PC, et al.: Placebo-controlled trial of safety and efficacy of intraoperative controlled delivery by biodegradable polymers of chemotherapy for recurrent gliomas. Lancet 345(8956): 1008-1012, 1995.
9. Brem H, Ewend MG, Piantadosi S, et al.: The safety of interstitial chemotherapy with BCNU-loaded polymer followed by radiation therapy in the treatment of newly diagnosed malignant gliomas: phase I trial. Journal of Neuro-Oncology 26(2): 111-123, 1995.

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