cizumab and its effect upon neuroimaging has
led to the development of new imaging criteria to
assess response to treatment, particularly in the
setting of anti-angiogenic agents.81 Recently, a device utilizing alternating electrical fields (NovoTTF,
Novocure, Portsmouth, NH) worn on the head was
approved by the FDA as monotherapy for recurrent
The likelihood of a patient becoming a 2-year
survivor increased from 10% with RT alone to
26% with the combination of radiation and TMZ.21
In subsequent long-term analysis, the likelihood
of becoming a 5-year survivor after initial treatment with radiation and concurrent TMZ was 9.8%
versus 1.9% with radiation alone.83 Validated prognostic factors which influence survival in glioblastoma include age, performance status, extent of
resection, and neurologic function.84 Other factors
which might affect prognosis include mental status
and tumor size.85 The role of molecular markers
beyond MGMT and IDH1 in stratifying patients into
prognostic categories is an important subject of
Glioblastoma represents one of the most ag-
gressive central nervous system neoplasms in
adults. Unfortunately, it is also the most common
malignant primary central nervous system tumor.
The advent of TMZ has increased survival and
solidified the role of chemotherapy in treating this
neoplasm. However, even with current standards
of care, more research is needed to stratify pa-
tients into prognostic categories and guide therapy.
Novel therapies are on the horizon for this and
other cancers; patients and their caregivers should
remain hopeful that research will lead to more ef-
fective and less toxic therapies in the near future.
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