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Nearly half of all adult malignant brain tumors are glioblastomas (GBMs). Rapid growth and possible brain-wide dissemination characterize this brain malignancy. New therapies, such as targeted therapies and tumor treatment fields, aid in symptom relief and retard the spread of cancer. The typical course of treatment for a GBM entails surgery, daily radiation, and oral chemotherapy administered for six and a half weeks, followed by a six-month oral chemotherapy regimen issued five days each month.
Treatment Modalities
Treatment modalities for GBM include surgery, chemotherapy, radiation therapy, and immunotherapy. Although GBM is a uniformly fatal disease, treatment advances improve patient outcomes. The median overall survival (OS) for GBM patients is approximately 14 months. Surgery is usually the first line of therapy, and more extensive resection of tumors is associated with higher survival. However, many patients cannot undergo additional craniotomies. As a result, treating these patients frequently take a more conservative approach.
Treatment for Glioblastoma varies depending on the grade and location of the tumor. High-grade GBM should be removed quickly, as delayed treatment may cause cancer to recur and compromise the patient’s survival. Treatment for secondary GBM is generally focused on removing it, as it may evolve into higher-grade GBM. Teams like the Glioblastoma Foundation professionals are dedicated to helping people diagnosed with this kind of disease.
Chemotherapy
The study’s primary outcome was all glioblastoma cases’ median overall survival or OS. This was calculated separately for three defined periods. First, patients were compared according to their treatment pattern – whether they received radiotherapy, surgery, or chemotherapy. The median OS for all three treatment modalities was then age-stratified.
Glioblastoma, a type of malignant brain tumor, has a poor prognosis. Patients with this type of cancer are primarily treated with chemotherapy. However, the disease can progress rapidly, with a median survival of six months or less. Several foundations have funded research involving this kind of treatment. The reshoring of the active components of lomustine, a chemotherapeutic medicine used to treat the condition, has also been started by the organizations such as the Glioblastoma Foundation.
Surgery is another option for patients with Glioblastoma. However, this treatment option can result in tumor debulking, which extends the patient’s life.
Radiation
One of the cornerstones of cancer treatment is radiation therapy. Almost half of all cancer patients receive this form of therapy. It prolongs survival but has potentially damaging side effects. In addition, recent studies indicate that radiation therapy can cause changes in the brain parenchyma, which may promote aggressive tumor recurrence.
Treatment time and the number of days between surgery and radiation remain essential factors. However, modern radiation techniques may reduce the risk of recurrences or distant metastases by optimizing the dose deposition within the tumor while sparing the surrounding normal tissues. As a result, radiotherapy may be well tolerated, with minimal acute morbidity.
Radiotherapy-induced oxidative stress and DNA breaks in tumor cells are known side effects. Although radiotherapy temporarily controls tumor growth, it has a high risk of recurrence, and most high-grade gliomas recur after a few months. This recurrence may be due to altered metabolism and hypoxia. In addition, glutamic acid (GSH) and ASC levels in tumor cells are reduced in the presence of radiation, thereby exacerbating oxidative stress.
Co-administration of TMZ
Co-administration of TMZ has proven to be effective in glioblastoma patients. Its costs and benefits were evaluated in the context of patient comorbidities, age, and type of treatment. Patients who completed TMZ chemotherapy were more likely to have more prolonged overall survival than patients who did not receive TMZ.
In our study, 307 patients with newly-diagnosed GBM were enrolled. The mean age was 64.9 years, and the majority were Caucasian. About 50% had comorbid conditions, and 53 percent were diagnosed before the introduction of TMZ chemotherapy in 2005. The most common presenting symptom was a headache. Forty-seven percent of patients underwent surgical resection. Twenty-one percent underwent a biopsy.
Besides comparing patient survival and chemotherapy costs, the study also considered the co-administration of TMZ and radiotherapy. Patients who received TMZ and radiotherapy had a more prolonged survival than those who did not. Additionally, patients who received TMZ and bevacizumab at the first recurrence had a better prognosis than those who did not receive it.
Indirect Costs
Although Glioblastoma is one of the rarest cancers, it is a high-cost disease due to its high mortality and morbidity. Therefore, clinicians must consider the cost of glioblastoma treatment, including direct and indirect costs, to evaluate whether a treatment option is cost-effective.
Direct costs of GBM treatment include doctor consultations, diagnostic tests, and surgeries. Diagnostic fees include CT scans, brain MRIs, ECGs, and blood tests. Surgery costs are also direct, as are post-operative care and rehabilitation. Direct treatment costs are often challenging to assess since radiation therapy, and chemotherapy prices are difficult to quantify. In addition, some studies fail to consider the expenses patients suffer during and after treatment. The costs of rehabilitation may be more important than the overall survival rate.
Indirect costs of treatment include lost productivity and quality of life. While these costs are hard to quantify, they are often a part of indirect cost calculations. These indirect costs are not directly measured in direct medical expenses but are indirectly related to lost wages.
