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Glioblastoma (Glioblastoma Multiforme)

The most aggressive primary brain tumor in adults with a poor prognosis despite multimodal therapy.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Onkoloji department. Book Appointment →

What is Glioblastoma (Glioblastoma Multiforme)?

Glioblastoma is a grade 4 astrocytic tumor and the most common malignant primary brain tumor in adults, accounting for approximately 50-60% of all gliomas. The current WHO 2021 classification recognizes glioblastoma as IDH-wildtype, distinguishing it from IDH-mutant astrocytomas which have a more favorable prognosis.

Glioblastoma is histologically characterized by hypercellularity, nuclear atypia, mitotic activity, microvascular proliferation, and pseudopalisading necrosis. Molecular hallmarks include EGFR amplification, PTEN loss, TERT promoter mutations, and chromosome 10 loss. MGMT promoter methylation status predicts response to temozolomide and is a key therapeutic biomarker.

Despite aggressive multimodal therapy with maximal safe surgical resection, radiation, and concurrent/adjuvant temozolomide (Stupp protocol), median overall survival remains approximately 15-18 months. Tumor treating fields (TTFields) added to maintenance temozolomide modestly extends survival. Inevitable recurrence is the rule and treatment options for recurrent disease are limited.

Symptoms

Progressive headache (often worse in morning)
New onset focal or generalized seizures
Cognitive decline or personality changes
Focal neurological deficits (hemiparesis, aphasia)
Visual field defects
Nausea and vomiting (raised intracranial pressure)
Confusion, disorientation, memory problems
Gait disturbance or imbalance
Sensory changes
Papilledema on fundoscopy

Risk Factors

Age over 50 (peak incidence 65-75 years)
Male sex (slight predominance)
Caucasian ethnicity
Prior cranial radiation exposure
Genetic syndromes: Li-Fraumeni, Lynch, NF1, Turcot, tuberous sclerosis (rare)
Most cases are sporadic without identifiable risk factors
No proven environmental risk factors
Mobile phone use is not an established risk factor

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • New onset persistent headache, especially morning headaches
  • First-ever seizure in adulthood
  • Progressive neurological symptoms (weakness, speech problems)
  • Cognitive or personality changes
  • Visual field disturbances
  • Nausea/vomiting with headache
  • Confusion or memory problems
  • Papilledema on routine eye examination
  • Any new focal neurological deficit

Treatment Methods

01
Maximal safe surgical resection: gross total resection improves survival
02
Adjuvant radiotherapy (60 Gy in 30 fractions) with concurrent temozolomide
03
Stupp protocol: temozolomide 75 mg/m2 daily during radiation
04
Adjuvant temozolomide (6 cycles): 150-200 mg/m2 days 1-5 every 28 days
05
MGMT methylation status: predicts temozolomide response
06
Tumor treating fields (TTFields, Optune): adds modest survival benefit
07
Bevacizumab: for symptomatic recurrence (palliative)
08
Lomustine (CCNU) or PCV regimen: salvage therapy
09
Reoperation: selected recurrent cases
10
Reirradiation: limited role in recurrent disease
11
Clinical trials: immunotherapy, targeted therapy, oncolytic viruses
12
Supportive care: anticonvulsants, dexamethasone for edema
13
Palliative care integration early in disease course
14
Molecular tumor board for IDH/MGMT/EGFR/TERT testing

Which Department to Visit?

You can visit our Onkoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.