Guidelines for the treatment of newly diagnosed glioblastoma: introduction

Abstract

Glioblastoma is a diagnosis familiar to all individuals whose practice of medicine deals with the nervous system. Of common concern is the recognition that glioblastoma is among the most difficult tumors to treat in oncology [1]. A review of Cushing’s experience over three decades showed he encountered no 5 year survivors [2, 3]. Subsequent populations based studies since then have shown little difference from that experience [4–9]. Certainly selected cases of long-term survival have been recognized and summary their clinical circumstances allow practitioners insight into individuals that may have better prognosis. However, this has not allowed practitioners to design a treatment at initial diagnosis that will guarantee such longterm control [10]. As there is a lack of reliably curative therapy for glioblastoma there is controversy on how to utilize the tools available. Experts in the field espouse a variety of surgical, radiation therapy and medically based therapies based on their experience their area of clinical experience or research interest. Perhaps the best opportunity for disease control with glioblastoma, as with other diseases, is at the time of initial diagnosis. Management of this disease is not confined to one intervention or one practitioner, but is multidisciplinary in nature. To explore the opportunity of early optimal intervention the disciplines most commonly involved the initial diagnosis and management of glioblastoma were chosen as the basis for development of this set of guidelines. The major goal of this guideline is to summarize the currently available knowledge related to the management of newly diagnosed glioblastoma in a manner that will serve as a point of departure for further research. The minor goal is to provide a scientific basis for current medical practice in the management of newly diagnosed glioblastoma.