Considerations and Treatments of Glioblastomas

1454 WordsFeb 17, 20186 Pages
Malignant gliomas are the most common type of primary malignant brain tumor, and glioblastoma accounts for 82% of cases of malignant glioma. Glioblastomas arise from glial precursor cells and are characterized histologically by considerable cellularity, mitotic activity, vascular proliferation, and necrosis. They are highly invasive, infiltrating surrounding brain tissues, yet they are typically confined to the central nervous system and do not metastasize.1 From a molecular standpoint, malignant glioblastomas are heterogeneous tumors, and genome studies have demonstrated four transcriptional subclasses. These four classes display features of distinct cell types: classical, mesenchymal, proneural, and neural.1 Patients with glioblastoma experience a wide variety of complications from both the disease and drug therapies. Current standard therapies for glioblastoma are maximal safe surgical resection followed by temozolomide and radiotherapy. With these therapies the median patient survival is less than 2 years due to common tumor recurrence.2 However, new therapies such as targeted vascular endothelial growth factor inhibitors, carmustine wafers, and gene therapies are promising in prolonging survival and delaying progression of the disease. Patients with glioblastoma experience clinical complications of the malignancy including thromboembolic events, seizures, fluctuations in neurologic symptoms, and visual field defects, in addition to adverse effects from
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