Glioblastoma multiforme:: Change in management strategies and outcome?

The overall prognosis for patients with glioblastoma multiforme (GBM) remains poor. These tumors are highly aggressive and often refractory to radiation and other adjuvant therapies in standard use today. The mean survival for most patients is still less than 24 months. Management therefore consists of tumor control without additional loss of quality of life. Surgery exhibits only one mode of the overall treatment plan. It decreases the tumor size and is therefore essential. Biopsy allows diagnosis and tumor grading. Radiation and chemotherapy are still adjuvant modes of therapy, but can extend the life span only briefly. Gene therapy is a new approach in the management of glioblastoma multiforme. The deregulated expression of one or more growth control genes including p16, p53, EGF receptor (EGFR), MDM2 or Bcl-2 may be responsible for the treatment resistance of the phenotype of GEM. However, there is no clinical evidence so far that gene therapy increases survival rates of patients with GEM.