This document presents a seminar on glioblastoma multiforme (GBM) by Nuhu Sani Usman. It discusses key topics such as epidemiology, pathogenesis, risk factors, symptoms, diagnosis and treatment of GBM. GBM is the most common malignant brain tumor in adults, occurring more often in males than females with an average age of diagnosis of 64 years. Symptoms vary depending on the location of the tumor but may include headaches, vomiting and seizures. Diagnosis involves neurological exams, imaging tests and biopsy. Treatment options include surgery, chemotherapy, radiation therapy and tumor treating fields therapy. However, survival rates for GBM remain poor with approximately 40% surviving one year and 17% surviving two years.
3. INTRODUCTION
• Glioblastoma is an aggressive type of cancer that can occur in the brain or
spinal cord. Glioblastoma forms from cells called astrocytes that support
nerve cells.
• Glioblastoma can occur at any age, but tends to occur more often in older
adults. It can cause worsening headaches, nausea, vomiting and seizures.
• Glioblastoma, also known as glioblastoma multiforme, can be very
difficult to treat and a cure is often not possible. (Khosla, 2016)
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4. EPIDEMIOLOGY
• About three per 100,000 people develop the disease a year, although
regional frequency may be much higher. The frequency in England doubled
between 1995 and 2015.
• It is the second-most common central nervous system cancer
after meningioma. It occurs more commonly in males than
females. Although the average age at diagnosis is 64. (Young et al., 2005)
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5. PATHOGENESIS
• The cellular origin of glioblastoma is unknown. Glioblastomas are
characterized by the presence of small areas of necrotizing tissue that are
surrounded by anaplastic cells.
• GBMs usually form in the cerebral white matter, grow quickly, and can
become very large before producing symptoms. Fewer than 10% form more
slowly following degeneration of low-grade astrocytoma or anaplastic
astrocytoma.
• These are called secondary GBMs and are more common in younger patients
(mean age 45 versus 62 years).
• Malignant cells carried in the CSF may spread (rarely) to the spinal cord or
cause meningeal gliomatosis. However, metastasis of GBM beyond
the central nervous system is extremely unusual. (Bleeker, 2012)
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6. RISK FACTOR
• Factors associated with glioblastoma risk are prior therapeutic
radiation, decreased susceptibility to allergy and impaired immune
response. Several hereditary cancer syndromes greatly increase the
risk of glioblastoma, including Li-fraumeni syndrome and Lynch
syndrome (Gallego, 2015)
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7. SYMPTOMS
• Symptoms vary depending on the location of the brain tumor, but may include any of the
following:
• Persistent headaches
• Double or blurred vision
• Vomiting
• Loss of appetite
• Changes in mood and personality
• Changes in ability to think and learn
• New onset of seizures
• Speech difficulty of gradual onset
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8. DIAGNOSIS
• Neurological exam. During a neurological exam, your doctor will ask you about your
signs and symptoms. He or she may check your vision, hearing, balance, coordination,
strength and reflexes.
• Imaging tests. Imaging tests can help your doctor determine the location and size of
your brain tumor.
• Removing a sample of tissue for testing (biopsy). A biopsy can be done with a needle
before surgery or during surgery to remove your glioblastoma, depending on your
particular situation and the location of your tumor. The sample of suspicious tissue is
analyzed in a laboratory to determine the types of cells and their level of
aggressiveness. (Ohgaki and Kleihues, 2005)
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9. PREVALENCE AND INCIDENCE
• Glioblastoma is the most common malignant brain and other CNS tumors
accounting for 47.7% of all cases. Glioblastoma has an incidence of 3.21
per 100,000 population.
• Median age of diagnosis is 64 years and it is more common in men as
compared to women. Survival is poor with approximately 40% survival
in the first year post diagnosis and 17% in the second year. (Van Meir et
al., 2010)
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10. PREVENTION
• There are no known methods to prevent glioblastoma. It is the case for
most gliomas, unlike for some other forms of cancer, that they happen
without previous warning and there are no known ways to prevent them.
(Huncharek et al., 2003)
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12. CONCLUSION
• Glioblastoma multiforme (GBM) is a fast-growing type of tumour of
the brain or spinal cord. It is the most common type of primary
malignant brain tumour in adults. GBMs almost never spread outside
of the brain, spine or central nervous system to other parts of the body.
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13. REFERENCES
• Bleeker, F.E., Molenaar, R.J., and Leenstra, S. (2012). "Recent advances in the molecular
understanding of glioblastoma". Journal of Neuro-Oncology. 108 (1): 11–27.
• Gallego, O. (2015). "Nonsurgical treatment of recurrent glioblastoma". Current Oncology. 22 (4):
e273–81.
• Huncharek, M., Kupelnick, B., and Wheeler, L., (2003). "Dietary cured meat and the risk of adult
glioma: a meta-analysis of nine observational studies". Journal of Environmental Pathology,
Toxicology and Oncology. 22 (2): 129–37.
• Khosla, D. (2016). "Concurrent therapy to enhance radiotherapeutic outcomes in
glioblastoma". Annals of Translational Medicine. 4 (3): 54.
• McNeill, K.A., (2016). "Epidemiology of Brain Tumors". Neurologic Clinics. 34 (4): 981–98.
• Ohgaki, H., and Kleihues, P., (2005). Journal of Neuropathology and Experimental
Neurology. 64 (6): 479–89. "Population-based studies on incidence, survival rates, and genetic
alterations in astrocytic and oligodendroglial gliomas".
• McFaline-Figueroa, J.R., and Wen, P.Y., (2017). "The Viral Connection to Glioblastoma". Current
Infectious Disease Reports. 19 (2): 5.
• Van Meir, E.G., Hadjipanayis, C.G., Norden, A.D., Shu, H.K., Wen, P.Y., and Olson, J.J.,
(2010). "Exciting new advances in neuro-oncology: the avenue to a cure for malignant glioma". CA:
A Cancer Journal for Clinicians. 60 (3): 166–93.
• Young, R.M., Jamshidi, A., Davis, G., and Sherman, J.H., (2015). "Current trends in the surgical
management and treatment of adult glioblastoma". Annals of Translational Medicine. 3 (9): 121.
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