Glioblastoma – the topical problem

In this article we present up to date information on the epidemiology, pathology and treatment modalities in patients with glioblastoma.

The primary brain tumors account for up 2% of all malignancies. Probability of morbidity rise with age, and it is 50/100 000 at the age of 75 years old. The etiology of brain tumors is unfortunately not clear, but increaesingly research is pointing toward genetic mutations.

Clinical presentation depends on tumor location, associated expansion, and surrounding edema. The neurologic effects of an intracranial tumor may be somewhat predicted by its location. With significant cerebral edema or hydrocephalus signs of increased intracranial pressure (nausea, vomiting, headache) and generalized cerebral dysfunction may predominate. It is significant that glioblastoma can cause neropsychological changes. The initial workup of patients with brain tumors must include a complete history, and a general physical examination. The most commonly useful is magnetic resonance imaging. Computed tomography scans with contrast material also are useful.

Current treatment recommendations call for maximal safe surgical resection followed by adjuvant irradiation with concurrent and adjuvant temozolomide. Treatment requires effective teamwork from neurosurgeons and radiation oncologists. The prognosis for patients with glioblastoma remain bad.