What Is Astrocytoma? What Is Glioblastoma?
According to available data, cancers of the brain and central nervous system account for over 200 new cases each year. Compared with more commonly known cancers such as lung cancer or liver cancer, they are relatively rare. However, whenever patients hear the term brain cancer, or learn that cancer has spread to the brain, it often causes significant fear and concern.
What Are Astrocytoma and Glioblastoma?
Glioblastoma multiforme (GBM) is a type of brain cancer known for its rapid growth and high recurrence rate.
Brain cancers can generally be divided into two types: metastatic brain tumours (cancer that has spread to the brain from other parts of the body) and primary brain tumours (cancers that originate in the brain itself).
Among primary brain tumours, the most common type is astrocytoma, which is classified into four grades. The most aggressive form is World Health Organization (WHO) grade IV glioblastoma multiforme, which grows very quickly. Without any treatment, the median survival time is only about three to four months.
How Is Glioblastoma Treated?
Surgical removal of the tumour can usually extend survival to around six months. If radiotherapy is added after surgery, survival may be extended to approximately 11 months.
Some patients can undergo a combined treatment approach, including surgery, radiotherapy, and chemotherapy. If the tumour shows expression of O6-methylguanine-DNA methyltransferase (MGMT), survival time may be significantly extended to around 21 months. Even when MGMT expression is absent, combined treatment may still extend survival to around 15 months.
Is the Recurrence Rate of Glioblastoma High?
A high recurrence rate is one of the biggest challenges in treating glioblastoma.
If the tumour recurs, doctors will first assess whether the patient can undergo another surgery or radiotherapy. If these options are no longer suitable, chemotherapy may be considered.
In recent years, research has shown that anti-angiogenic targeted therapies can block the formation of new blood vessels that supply cancer cells, helping to shrink brain tumours. These treatments are sometimes used together with chemotherapy.
A Clinical Case Example
Recently, a man in his 60s experienced difficulty moving the right side of his body. After medical evaluation, he was diagnosed with a glioblastoma multiforme located in the left frontal lobe of the brain.
Doctors surgically removed the tumour and conducted laboratory testing, which confirmed the presence of MGMT expression. The patient then underwent radiotherapy combined with daily oral chemotherapy, and his condition remained stable.
Unfortunately, the tumour recurred six months later, and the patient again experienced reduced mobility on the right side of his body. As further surgery or radiotherapy was no longer possible, chemotherapy was restarted.
After three cycles of chemotherapy, the tumour shrank. However, the patient’s bone marrow function could no longer tolerate further treatment, and chemotherapy had to be stopped.
Three months later, doctors observed that the tumour had grown larger again, with worsening brain swelling (oedema). They therefore initiated anti-angiogenic targeted therapy combined with chemotherapy.
After four treatment cycles, the patient’s symptoms improved. The tumour became slightly smaller, and the brain swelling was relieved. The patient has now begun his eighth cycle of treatment.
Conclusion
Although treating glioblastoma is extremely challenging, using multiple treatment strategies together can still help extend a patient’s survival and improve quality of life.
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