Abstract
Glioblastoma (GBM) is the most common primary brain tumor. Despite aggressive treatment, GBM almost always recurs. The current standard-of-care for treatment of newly diagnosed GBM has remained relatively unchanged since 2005: maximal safe resection followed by concomitant chemoradiation (CRT) with temozolomide (TMZ), and subsequent adjuvant TMZ. In 2011, the first-generation tumor treating fields (TTF) device, known at the time as the NovoTTF-100A System (renamed Optune), was approved by the Food and Drug Administration (FDA) for treatment of recurrent GBM. The TTF device was subsequently approved as an adjuvant therapy for newly-diagnosed GBM in 2015. The following is a review of the TTF device, including evidence supporting its use and limitations.
Highlights
Glioblastoma (GBM) is the most aggressive and common primary brain tumor
Relevance of topics was selected based on talking points at the 2018 American Society for Radiation Oncology (ASTRO) conference and common questions proposed by the patients and practicing clinicians at our institution
The analysis found that deterioration-free survival was longer in patients receiving treating fields (TTF) therapy for global health, physical and emotional functioning [29]
Summary
Glioblastoma (GBM) is the most aggressive and common primary brain tumor. Treatment remains challenging, as GBM inevitably recurs despite surgical debulking, radiation and chemotherapy.The current standard-of-care is comprised of maximal safe resection—gross total resection if feasible—followed by chemoradiation (CRT). Glioblastoma (GBM) is the most aggressive and common primary brain tumor. As GBM inevitably recurs despite surgical debulking, radiation and chemotherapy. The current standard-of-care is comprised of maximal safe resection—gross total resection if feasible—followed by chemoradiation (CRT). Radiation therapy consists of 60 Gray (Gy) in 30 fractions over a period of 6 weeks with concomitant daily temozolomide (TMZ), followed by adjuvant TMZ (days 1–5 every 28 days). Median survival ranges from twelve to fifteen months following diagnosis and treatment [1]. The current five-year survival rate is about five percent in the United States [2]
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