Glioblastoma Multiforme (GBM)

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Diagnosing and Treating Glioblastoma Multiforme

A patient with any neurological symptoms will first be given a physical exam that includes neurologic function tests (reflexes, muscle strength, eye and mouth movement, coordination and alertness). If a tumor is suspected, the patient will have imaging tests so that doctors can look into the brain for any abnormality. These tests may include:

Magnetic resonance imaging (MRI) and computerized tomography (CT) scans produce detailed images of the brain and spine and allow doctors to detect the presence of a tumor.  MRI scans provide the best images of glioblastoma multiforme; those scans are usually done with a contrast agent (dye) to help distinguish the tumor from normal brain tissue.

A surgical biopsy may be performed to help confirm the diagnosis. In this procedure, a neurosurgeon extracts a small sample of abnormal cells to test in a pathology laboratory. The main clue to a tumor’s being glioblastoma multiforme is the cell necrosis, or cell death, that is characteristic of GBM.

Treatment Options
If left untreated, glioblastoma multiforme is fatal within weeks or months. With aggressive treatment at a major medical center, a patient diagnosed with GBM can extend his or her survival time to months or even years.

A multidisciplinary team like the one at the Weill Cornell Brain and Spine Center evaluates each patient and recommends an individual treatment plan. Treatment for glioblastoma multiforme usually includes a combination of surgery, chemotherapy, radiation, or stereotactic radiosurgery.  Patients should have surgery to remove as much of the tumor as possible, or to relieve pressure (see Surgery for Glioblastoma Multiforme).  Other treatments include:

Chemotherapy may be used to help shrink a tumor, or as follow-up after surgery to kill off any cancer cells left behind. It is given systemically (meaning to the whole body, not just to the site of the tumor) and may be a pill, an injection, or an IV drip.  Novel treatments at Weill Cornell use intra-arterial methods to improve the efficacy of chemotherapy. (More about these clinical trials.)

Radiation therapy may help control the growth of the tumor and may be used instead of or in addition to surgery. Traditional radiation therapy can be an alternative to surgery or can kill cancer cells left behind after surgery.   In one groundbreaking development, surgeons are testing a new procedure in which radioactive cesium-131 “seeds” are implanted at the tumor site during surgery to remove it; this allows radiation to begin targeting any remaining cancer cells immediately, rather than waiting for a patient to recover from surgery before beginning radiation. (See more about the cesium-131 trial.)

Stereotactic radiosurgery is not traditional surgery at all, but highly focused beams of radiation aimed at a tumor from multiple angles. Commonly known by the names of the machines used — including CyberKnife, Gamma Knife, or LINAC (linear accelerator) — stereotactic radiosurgery is an advanced specialty best performed by highly trained specialists in the field. (See more about the Stereotactic Radiosurgery Program.)

Other treatments may include steroid treatment to reduce swelling, or anti-seizure medication. Researchers are now investigating other treatments, including immunotherapy and gene therapy.  Find out more about brain tumor research and brain tumor clinical trials at the Weill Cornell Brain and Spine Center.

The prognosis for glioblastoma multiforme remains poor, but treatment can prolong life and preserve function while laboratory researchers continue to search for better alternatives.

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Reviewed by: Rohan Ramakrishna, M.D.
Last reviewed/last updated: January 2015