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Gbm Treatment Essay

633 words - 3 pages

Glioblastoma Multiforme (GMB) is the most common form of primary malignant brain tumor in adults. With the current standard therapy, median survival time hovers just over 12 months. This incurable disease is devastating with a median survival time of 6-8 months from time of recurrence (J10). The current standard of therapy at first diagnosis consists of surgery followed by radiotherapy with concommittant and adjuvant chemotherapy using the agent temozolamide (TMZ) (Multiple sources). In 2003, the United States Food and Drug administration approved the Gliadel Wafer (GW) for treatment of newly diagnosed GBM (C3). The monoclonal antibody Bevacizumab (BEV) was first used to treat recurrent GBM in 2005 and has a significant survival benefit for patients with grade IV glioma (E5). Many more promising avenues for new treatment have been and are currently being studied. Such areas include the use of antiepileptic drugs, using Convection-Enhanced Delivery of chemotherapeutic agents, and targeting specific molecular markers and pathways such as the epidermal growth factor receptor (EGFR), O6-methylguanine-DNA-methyltransferase (MGMT), and the PI3K/Akt/mTOR pathway.
CURRENT STANDARD OF THERAPY
The current standard of therapy is resection of the tumor plus radiotherapy and TMZ (E5). Multiple studies performed between 1976 and 1991 have led postoperative radiotherapy to be accepted as standard treatment (L12). The universal dosing schedule for radiotherapy in GBM is fractionated irradiation over 6-7 weeks for a total of 60 gray (Gy) (G7,M13). TMZ is an oral alkylating agent that can be used concomitant with radiotherapy and as an adjuvant. The European Organization for Research and Treatment of Cancer (EORTC) and the National Cancer Institute of Canada (NCIC) organized a study showing that adding TMZ to standard radiotherapy is beneficial to overall survival. This study enrolled 573 patients from 85 institutions and randomly assigned eligible patients to receive either standard radiotherapy...

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