Q: WHAT ARE THE CURRENT TREATMENT OPTIONS FOR GBM?
A: Surgery is the chief form of treatment for a GBM tumour that can be removed without damaging critical neurological functions. Because a tumour will recur if any tumour cells are left behind, the surgeon's goal is to remove the entire tumour whenever possible. Radiation therapy and chemotherapy, in general, are used as secondary or adjuvant treatment for tumours that cannot be cured by surgery alone.

Steroids and anti-convulsants are the most common medications used for brain tumour patients. Steroids are given to reduce inflammation of tissues and control swelling of the brain, particularly before and after surgery. They do not kill tumour cells, but may improve a patient's condition when used alone or in combination with other forms of treatment. Anti-convulsants are used to keep seizures from occurring or cut short seizures that have already started. It is important to remember that side effects of these drugs vary greatly from person to person.

Radiation therapy is primarily used after surgery for tumours that cannot be removed completely, as well as for cases in which surgery would involve too great a risk to the patient. Radiation may be given in a single dose each day, usually for 30 days with weekends off, or it may be "hyperfractionated" into two or more doses daily for the recommended course of treatment.

Standard radiation therapy delivers an external beam of radiation aimed at an entire region, such as the portion of the brain containing the tumour and typically delivers a daily dose of 1.8-2.0 Gy (Gray) to a total dose of 50-60 Gy over 5-7 weeks.

Chemotherapy works to destroy tumour cells with drugs that may be given either alone or in combination with other treatments. A key problem with chemotherapy has been the difficulty in delivering sufficient amounts of drug directly to the tumour while sparing normal brain cells. Another problem is the blood-brain barrier mechanism that normally keeps harmful substances out of the brain - unfortunately, this same blood-brain barrier can also keep potentially helpful drugs out of the brain. Although chemotherapy is typically given orally or injected in the vein, some new techniques of intratumoural chemotherapy use either small pumps or biodegradable wafers to place the drug inside the tumour.

Stereotactic radiosurgery, also known as "gamma-knife," is a non-invasive therapeutic alternative for treating brain disorders. Instead of a scalpel, clinicians using stereotactic radiosurgery technology to aim multiple "pencil-thin" beams or arched beams of high-energy particles directly at the tumour site, while sparing as much healthy tissue as possible.



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