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The “Radioresistance” of Glioblastoma in the Clinical Setting, and the Present Therapeutic Options

  • Michela BuglioneEmail author
  • Luca Triggiani
  • Paolo Borghetti
  • Sara Pedretti
  • Nadia Pasinetti
  • Stefano Maria Magrini
Chapter
  • 641 Downloads
Part of the Current Clinical Pathology book series (CCPATH)

Abstract

Malignant Glioma is the most common intra axial tumor in the adult, with a yearly incidence of 4–5 per 100,000 people (Central Brain Tumor Registry of the United States (CBTRUS), 2011). It can occur in all age groups, but it is prevalent in adults over 45 years of age (Central Brain Tumor Registry of the United States (CBTRUS), 2011). Among the several classification systems, the one supplied by World Health Organization (WHO) is the most widely used: 4 classes are described, according to malignancy and histological features (Louis et al., Acta Neuropathol 114(2):97–109, 2007). The term “glioma” refers to tumors defined as astrocytomas, oligodendrogliomas, or oligoastrocytomas among others. Once microvascular proliferation and necrosis are observed, gliomas are categorized as grade IV, or Glioblastoma (GBM) (Louis et al., Acta Neuropathol 114(2):97–109, 2007; Dunn et al., Genes Dev 26(8):756–84, 2012; Huse et al., Glia 59:1190–9, 2011). Approximately half of the newly diagnosed GBM patients have an extremely poor prognosis. Despite many successful achievements in different areas of oncology, prognosis of GBM has not changed over the past 30 years, except for a moderate benefit acquired with the so-called “Stupp’s protocol” (Stupp et al., N Engl J Med 352(10):987–96). Literature on the treatment of GBM has been characterized by different promising Phase-II trials unconfirmed in subsequent Phase-III trials. At present, this scenario might be improved by the effort to overcome GBM radioresistance by means of different methods, like dose escalation, unconventional fractionation, better volume delineation, and association with chemo- and targeted therapy.

Keywords

Glioblastoma Radiotherapy Local recurrence Dose escalation Hypofractionation Hyperfractionation Stereotactic Brachytherapy Radiation volume Advanced imaging Targeted therapies 

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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Michela Buglione
    • 1
    Email author
  • Luca Triggiani
    • 1
  • Paolo Borghetti
    • 1
  • Sara Pedretti
    • 2
  • Nadia Pasinetti
    • 1
  • Stefano Maria Magrini
    • 1
  1. 1.Radiation Oncology DepartmentUniversity and Spedali Civili - BresciaBresciaItaly
  2. 2.Radiation Oncology DepartmentSpedali Civili, University of BresciaBresciaItaly

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