Standard Treatment
If you were recently diagnosed with glioblastoma multiforme and have not yet begun most treatment, please read Upon Diagnosis before continuing this section.
Standard treatment for a glioblastoma brain tumor usually follows a
standardized, one-size-fits-all set of treatments given in chronological order. Glioblastomas are highly heterogeneous person to person, and better cancer centers
will offer more tailored treatment plans.
Click on the image to the right to view a flow chart of the current standard
treatment, its general timeframe and the corresponding Karnofsky Performance
Status.
Standard treatment leaves much to be desired. Mean overall survival for the
standard treatment is about 1 year from diagnosis. Your treatment goal should be
to improve these odds. Many factors may
help improve individual odds of surviving glioblastoma and these factors are discussed in
Improving Standard Treatment.
To help better understand standard glioblastoma treatment, the primary
procedures of the treatment are described in greater detail below:
1. Maximum tumor resection |
Tumor resection usually occurs within days after diagnosis. The procedure involves a craniotomy and removal of as much tumor as possible. |
2. Radiotherapy plus concomitant and adjuvant temozolomide |
After recovery from the initial craniotomy, standard radiation therapy begins, usually in the form of 30 external beam radiation treatments of 2 Gy each over the course of 6 weeks, for a total of 60 Gy of fractionated radiation. During these 6 weeks, the patient also receives daily chemotherapy using temozolomide at a dosage of 75 mg/m2/day. |
3. Up to 1 year of temozolomide chemotherapy |
Standard temozolomide chemotherapy consists of 150 to 200 mg/m2/day of temozolomide for 5 days followed by 23 days of rest (the 5/23 schedule) in 28 day cycles. |
4. Additional surgeries, experimental treatments or palliative care |
The range of treatments utilized in this phase of treatment is diverse, including specialized radiotherapy, surgery, chemotherapy, experimental treatments, and palliative care. |
Much of this protocol was established in a landmark study published in 2005 in
the New England Journal of Medicine by Dr. Roger Stupp and an international
team of researchers. You can read the entire Stupp paper on the NEJM web site.
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