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Glioblastoma

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five-month improvement in overall survival compared to temozolomide therapy alone, representing the first large trial in a decade to show a survival improvement in this setting. Despite these results, the efficacy of this approach remains controversial among medical experts. However, increasing understanding of the mechanistic basis through which alternating electric field therapy exerts anti-cancer effects and results from ongoing phase-III clinical trials in extracranial cancers may help facilitate increased clinical acceptance to treat glioblastoma in the future.
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cancer. Despite countless efforts to develop new therapies for GBM over the years, the median survival rate of GBM patients worldwide is 8 months; radiation and chemotherapy standard-of-care treatment beginning shortly after diagnosis improve the median survival length to around 14 months and a five-year survival rate of 5–10%. The five-year survival rate for individuals with any form of primary malignant brain tumor is 20%. Even when all detectable traces of the tumor are removed through surgery, most patients with GBM experience recurrence of their cancer.
1164:. A pivotal clinical trial carried out in the early 1970s showed that among 303 GBM patients randomized to radiation or best medical therapy, those who received radiation had a median survival more than double those who did not. Subsequent clinical research has attempted to build on the backbone of surgery followed by radiation. Whole-brain radiotherapy does not improve when compared to the more precise and targeted three-dimensional conformal radiotherapy. A total radiation dose of 60–65 Gy has been found to be optimal for treatment. 1464:. PPT refers to polyetherimide, PEG and trans-activator of transcription, and TRAIL is the human tumor necrosis factor-related apoptosis-induced ligand) for effective gene delivery and tracking, with positive results. This is a TRAIL ligand that has been encoded to induce apoptosis of cancer cells, more specifically glioblastomas. Although this study was still in clinical trials in 2017, it has shown diagnostic and therapeutic functionalities, and will open great interest for clinical applications in stem-cell-based therapy. 911: 1137:. GBM cells are widely infiltrative through the brain at diagnosis, and despite a "total resection" of all obvious tumor, most people with GBM later develop recurrent tumors either near the original site or at more distant locations within the brain. Other modalities, typically radiation and chemotherapy, are used after surgery in an effort to suppress and slow recurrent disease through damaging the DNA of rapidly proliferative GBM cells. 891: 795:) have been found in glioblastomas. Their presence, coupled with the glioblastoma's diffuse nature results in difficulty in removing them completely by surgery, and is therefore believed to be the possible cause behind resistance to conventional treatments, and the high recurrence rate. Glioblastoma cancer stem cells share some resemblance with neural progenitor cells, both expressing the surface receptor 994: 1513: 1290:
temozolomide chemotherapy and better KPSs. A recent study confirms that younger age is associated with a much better prognosis, with a small fraction of patients under 40 years of age achieving a population-based cure. Cure is thought to occur when a person's risk of death returns to that of the normal population, and in GBM, this is thought to occur after 10 years.
951:) and have not progressed from a lower-grade glioma, as in high-grade astrocytomas Glioblastomas have a worse prognosis and different tumor biology, and may have a different response to therapy, which makes this a critical evaluation to determine patient prognosis and therapy. Astrocytomas carry a mutation in 1236:
is an FDA-approved therapy for newly diagnosed and recurrent glioblastoma. In 2015, initial results from a phase-III randomized clinical trial of alternating electric field therapy plus temozolomide in newly diagnosed glioblastoma reported a three-month improvement in progression-free survival, and a
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Tumors of the central nervous system are the 10th leading cause of death worldwide, with up to 90% being brain tumors. Glioblastoma multiforme (GBM) is derived from astrocytes and accounts for 49% of all malignant central nervous system tumors, making it the most common form of central nervous system
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is an emerging novel treatment that is under investigation both at preclinical and clinical stages. Several viruses including herpes simplex virus, adenovirus, poliovirus, and reovirus are currently being tested in phases I and II of clinical trials for glioblastoma therapy and have shown to improve
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has been explored as a method to treat glioblastoma, and while animal models and early-phase clinical trials have been successful, as of 2017, all gene-therapy drugs that had been tested in phase-III clinical trials for glioblastoma had failed. Scientists have developed the core–shell nanostructured
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Long-term benefits have also been associated with those patients who receive surgery, radiotherapy, and temozolomide chemotherapy. However, much remains unknown about why some patients survive longer with glioblastoma. Age under 50 is linked to longer survival in GBM, as is 98%+ resection and use of
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Most studies show no benefit from the addition of chemotherapy. However, a large clinical trial of 575 participants randomized to standard radiation versus radiation plus temozolomide chemotherapy showed that the group receiving temozolomide survived a median of 14.6 months as opposed to 12.1 months
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The greater the extent of tumor removal, the better. In retrospective analyses, removal of 98% or more of the tumor has been associated with a significantly longer healthier time than if less than 98% of the tumor is removed. The chances of near-complete initial removal of the tumor may be increased
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published the first standard classification in 1979 and has been doing so since. The 2007 WHO Classification of Tumors of the Central Nervous System was the last classification mainly based on microscopy features. The new 2016 WHO Classification of Tumors of the Central Nervous System was a paradigm
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GBM is characterized by abnormal vessels that present disrupted morphology and functionality. The high permeability and poor perfusion of the vasculature result in a disorganized blood flow within the tumor and can lead to increased hypoxia, which in turn facilitates cancer progression by promoting
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found that the overall benefit of anti-angiogenic therapies was unclear. In elderly people with newly diagnosed glioblastoma who are reasonably fit, concurrent and adjuvant chemoradiotherapy gives the best overall survival but is associated with a greater risk of haematological adverse events than
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with tumor resection and pathologic confirmation. Because the tumor grade is based upon the most malignant portion of the tumor, biopsy or subtotal tumor resection can result in undergrading of the lesion. Imaging of tumor blood flow using perfusion MRI and measuring tumor metabolite concentration
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In 2021, the fifth edition of the WHO Classification of Tumors of the Central Nervous System was released. This update eliminated the classification of secondary glioblastoma and reclassified those tumors as Astrocytoma, IDH mutant, grade 4. Only tumors that are IDH wild type are now classified as
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Despite maximum treatment, the cancer almost always recurs. The typical duration of survival following diagnosis is 10–13 months, with fewer than 5–10% of people surviving longer than five years. Without treatment, survival is typically three months. It is the most common cancer that begins within
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therapy is a two step approach which includes the delivery of a foreign enzyme-gene to the cancer cells followed by activation with an pro-drug causing toxicities in the cancer-cells which induces cell death. This approach have had success in animal models and small clinical studied but could not
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GBMs usually form in the cerebral white matter, grow quickly, and can become very large before producing symptoms. Since the function of glial cells in the brain is to support neurons, they have the ability to divide, to enlarge, and to extend cellular projections along neurons and blood vessels.
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Between 60-85% of glioblastoma patients report cancer-related cognitive impairments following surgery, which refers to problems with executive functioning, verbal fluency, attention, speed of processing. These symptoms may be managed with cognitive behavioral therapy, physical exercise, yoga and
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R132H suffices for the classification as IDH-wild-type glioblastoma. In all other instances of diffuse gliomas, a lack of IDH1 R132H immunopositivity should be followed by IDH1 and IDH2 DNA sequencing to detect or exclude the presence of non-canonical mutations. IDH-wild-type diffuse astrocytic
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Historically, around 90% of patients with glioblastoma underwent anticonvulsant treatment, although only an estimated 40% of patients required this treatment. Neurosurgeons have recommended that anticonvulsants not be administered prophylactically, and should wait until a seizure occurs before
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The most common length of survival following diagnosis is 10 to 13 months (although recent research points to a median survival rate of 15 months), with fewer than 1–3% of people surviving longer than five years. In the United States between 2012 and 2016 five-year survival was 6.8%. Without
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Surgery is the first stage of treatment of glioblastoma. An average GBM tumor contains 10 cells, which is on average reduced to 10 cells after surgery (a reduction of 99%). Benefits of surgery include resection for a pathological diagnosis, alleviation of symptoms related to mass effect, and
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Stupp R, Hegi ME, Mason WP, van den Bent MJ, Taphoorn MJ, Janzer RC, et al. (May 2009). "Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trial".
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O movement through osmosis, which aids glioblastoma cells in changing cellular volume very rapidly. This is helpful in their extremely aggressive invasive behavior because quick adaptations in cellular volume can facilitate movement through the sinuous extracellular matrix of the brain.
346:, changes to personality, mood or concentration, and localized neurological problems. The kinds of symptoms produced depend more on the location of the tumor than on its pathological properties. The tumor can start producing symptoms quickly, but occasionally is an 5594:
The use of anti-angiogenic therapy does not significantly improve overall survival in newly diagnosed people with glioblastoma. Thus, there is insufficient evidence to support the use of anti-angiogenic therapy for people with newly diagnosed glioblastoma at this
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of glioblastoma, showing high grade astrocytoma features of marked nuclear pleomorphism, multiple mitoses (one at white arrow) and multinucleated cells (one at black arrow), with cells having a patternless arrangement in a pink fibrillary background on H&E
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Fulton DS, Urtasun RC, Scott-Brown I, Johnson ES, Mielke B, Curry B, et al. (September 1992). "Increasing radiation dose intensity using hyperfractionation in patients with malignant glioma. Final report of a prospective phase I-II dose response study".
1171:, which are highly resistant to radiotherapy. Various approaches to chemotherapy radiosensitizers have been pursued, with limited success as of 2016. As of 2010, newer research approaches included preclinical and clinical investigations into the use of an 1010: 1492:
Direct nose-to-brain drug delivery is being explored as a means to achieve higher, and hopefully more effective, drug concentrations in the brain. A clinical phase-I/II study with glioblastoma patients in Brazil investigated the natural compound
734:, a "suicide" DNA repair enzyme. Methylation impairs DNA transcription and expression of the MGMT gene. Since the MGMT enzyme can repair only one DNA alkylation due to its suicide repair mechanism, reserve capacity is low and methylation of the 5365:
Stupp R, Mason WP, van den Bent MJ, Weller M, Fisher B, Taphoorn MJ, et al. (European Organisation for Research Treatment of Cancer Brain Tumor Radiotherapy Groups, National Cancer Institute of Canada Clinical Trials Group) (March 2005).
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can also be used as a cancer stem cell marker in a subset of glioblastoma tumour cells. Glioblastoma cancer stem cells appear to exhibit enhanced resistance to radiotherapy and chemotherapy mediated, at least in part, by up-regulation of the
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expression compared with IDH-mutant lower grade astrocytomas. In patients aged over 55 years with a histologically typical glioblastoma, without a pre-existing lower grade glioma, with a non-midline tumor location and with retained nuclear
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may add diagnostic value to standard MRI in select cases by showing increased relative cerebral blood volume and increased choline peak, respectively, but pathology remains the gold standard for diagnosis and molecular characterization.
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mutations are a useful tool to distinguish glioblastomas from astrocytomas, since histopathologically they are similar and the distinction without molecular biomarkers is unreliable. IDH-wildtype glioblastomas usually have lower
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Stummer W, Pichlmeier U, Meinel T, Wiestler OD, Zanella F, Reulen HJ (May 2006). "Fluorescence-guided surgery with 5-aminolevulinic acid for resection of malignant glioma: a randomised controlled multicentre phase III trial".
1415:. It occurs more commonly in males than females. Although the median age at diagnosis is 64, in 2014, the broad category of brain cancers was second only to leukemia in people in the United States under 20 years of age. 988:
gliomas without microvascular proliferation or necrosis should be tested for EGFR amplification, TERT promoter mutation and a +7/–10 cytogenetic signature as molecular characteristics of IDH-wild-type glioblastomas.
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Molenaar RJ, Radivoyevitch T, Maciejewski JP, van Noorden CJ, Bleeker FE (December 2014). "The driver and passenger effects of isocitrate dehydrogenase 1 and 2 mutations in oncogenesis and survival prolongation".
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Lacroix M, Abi-Said D, Fourney DR, Gokaslan ZL, Shi W, DeMonte F, et al. (August 2001). "A multivariate analysis of 416 patients with glioblastoma multiforme: prognosis, extent of resection, and survival".
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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.
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Walker MD, Alexander E, Hunt WE, MacCarty CS, Mahaley MS, Mealey J, et al. (September 1978). "Evaluation of BCNU and/or radiotherapy in the treatment of anaplastic gliomas. A cooperative clinical trial".
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Initial analyses of gene expression had revealed a fourth neural subtype. However, further analyses revealed that this subtype is non-tumor specific and is potential contamination caused by the normal cells.
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The cause of most cases is unclear. The best known risk factor is exposure to ionizing radiation, and CT scan radiation is an important cause. About 5% develop from certain hereditary syndromes.
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Martinez R, Schackert G, Yaya-Tur R, Rojas-Marcos I, Herman JG, Esteller M (May 2007). "Frequent hypermethylation of the DNA repair gene MGMT in long-term survivors of glioblastoma multiforme".
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Dall'oglio S, D'Amico A, Pioli F, Gabbani M, Pasini F, Passarin MG, et al. (December 2008). "Dose-intensity temozolomide after concurrent chemoradiotherapy in operated high-grade gliomas".
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show survival benefit in larger clinical studies. Using new more efficient delivery vectors and suicide gene-prodrug systems could improve the clinical benefit from these types of therapies.
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Peterson A, Bansal A, Hofman F, Chen TC, Zada G (February 2014). "A systematic review of inhaled intranasal therapy for central nervous system neoplasms: an emerging therapeutic option".
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Wu SQ, Yang CX, Yan XP (March 2017). "A Dual-Functional Persistently Luminescent Nanocomposite Enables Engineering of Mesenchymal Stem Cells for Homing and Gene Therapy of Glioblastoma".
4579: 1111:, can reduce peritumoral edema (through rearrangement of the blood–brain barrier), diminishing mass effect and lowering intracranial pressure, with a decrease in headache or drowsiness. 322:, which is benign in most cases. About 3 in 100,000 people develop the disease per year. The average age at diagnosis is 64, and the disease occurs more commonly in males than females. 6878:
Pardeshi CV, Belgamwar VS (July 2013). "Direct nose to brain drug delivery via integrated nerve pathways bypassing the blood-brain barrier: an excellent platform for brain targeting".
861:, usually microRNA, was under investigation in tissue culture, pathology specimens, and preclinical animal models of glioblastoma. Additionally, experimental observations suggest that 5232:
Showalter TN, Andrel J, Andrews DW, Curran WJ, Daskalakis C, Werner-Wasik M (November 2007). "Multifocal glioblastoma multiforme: prognostic factors and patterns of progression".
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Visser O, Ardanaz E, Botta L, Sant M, Tavilla A, Minicozzi P (October 2015). "Survival of adults with primary malignant brain tumours in Europe; Results of the EUROCARE-5 study".
7658: 3906:"Stem cell-related "self-renewal" signature and high epidermal growth factor receptor expression associated with resistance to concomitant chemoradiotherapy in glioblastoma" 5468:
Chamberlain MC, Glantz MJ, Chalmers L, Van Horn A, Sloan AE (March 2007). "Early necrosis following concurrent Temodar and radiotherapy in patients with glioblastoma".
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Furnari FB, Fenton T, Bachoo RM, Mukasa A, Stommel JM, Stegh A, et al. (November 2007). "Malignant astrocytic glioma: genetics, biology, and paths to treatment".
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greatly affects DNA-repair capacity. MGMT methylation is associated with an improved response to treatment with DNA-damaging chemotherapeutics, such as temozolomide.
1286:. Patients with a methylated MGMT promoter have longer survival than those with an unmethylated MGMT promoter, due in part to increased sensitivity to temozolomide. 1404:
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.
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may be used to help reduce swelling and decrease symptoms. Surgical removal (decompression) of the tumor is linked to increased survival, but only by some months.
844:. By upregulating these ion channels, glioblastoma tumor cells are hypothesized to facilitate increased ion movement over the cell membrane, thereby increasing H 5351:
for "Safety and Efficacy Study of Trans Sodium Crocetinate (TSC) With Concomitant Radiation Therapy and Temozolomide in Newly Diagnosed Glioblastoma (GBM)" at
764:) are all recognized by transmembrane proteins called RTKs. Additionally, they can function as receptors for hormones, cytokines, and other signaling pathways. 7090: 5311:
Sheehan JP, Shaffrey ME, Gupta B, Larner J, Rich JN, Park DM (October 2010). "Improving the radiosensitivity of radioresistant and hypoxic glioblastoma".
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Mason WP, Mirimanoff RO, Stupp R (2006). "Radiotherapy with Concurrent and Adjuvant Temozolomide: A New Standard of Care for Glioblastoma Multiforme".
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Hardell L, Carlberg M, Hansson Mild K (August 2009). "Epidemiological evidence for an association between use of wireless phones and tumor diseases".
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Brown DV, Stylli SS, Kaye AH, Mantamadiotis T (2019). "Multilayered Heterogeneity of Glioblastoma Stem Cells: Biological and Clinical Significance".
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for the group receiving radiation alone. This treatment regimen is now standard for most cases of glioblastoma where the person is not enrolled in a
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Once cancerous, these cells are predisposed to spread along existing paths in the brain, typically along white-matter tracts, blood vessels and the
433:, such as from cell phones and electrical wiring within homes, have been studied as risk factors. As of 2015, they had not been shown to cause GBM. 3569:"Integrated genomic analysis identifies clinically relevant subtypes of glioblastoma characterized by abnormalities in PDGFRA, IDH1, EGFR, and NF1" 1926:
Tan AC, Ashley DM, LĂłpez GY, Malinzak M, Friedman HS, Khasraw M (July 2020). "Management of glioblastoma: State of the art and future directions".
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promoter methylation. High doses of temozolomide in high-grade gliomas yield low toxicity, but the results are comparable to the standard doses.
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Subsequent to surgery, radiotherapy becomes the mainstay of treatment for people with glioblastoma. It is typically performed along with giving
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Smoll NR, Brady Z, Scurrah K, Mathews JD (June 2016). "Exposure to ionizing radiation and brain cancer incidence: The Life Span Study cohort".
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is extremely unusual. About 50% of GBMs occupy more than one lobe of a hemisphere or are bilateral. Tumors of this type usually arise from the
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Huncharek M, Kupelnick B, Wheeler L (2003). "Dietary cured meat and the risk of adult glioma: a meta-analysis of nine observational studies".
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When viewed with MRI, glioblastomas often appear as ring-enhancing lesions. The appearance is not specific, however, as other lesions such as
5442: 6329:"Geographic Variations in the Incidence of Glioblastoma and Prognostic Factors Predictive of Overall Survival in US Adults from 2004–2013" 6296:"Reexamining the radiation therapy oncology group (RTOG) recursive partitioning analysis (RPA) for glioblastoma multiforme (GBM) patients" 7521: 6095:"A very rare case report of long-term survival: A patient operated on in 1994 of glioblastoma multiforme and currently in perfect health" 2274: 5748: 4446:
Smirniotopoulos JG, Murphy FM, Rushing EJ, Rees JH, Schroeder JW (2007). "Patterns of contrast enhancement in the brain and meninges".
3707:"The combination of IDH1 mutations and MGMT methylation status predicts survival in glioblastoma better than either IDH1 or MGMT alone" 5775:"Maintenance Therapy With Tumor-Treating Fields Plus Temozolomide vs Temozolomide Alone for Glioblastoma: A Randomized Clinical Trial" 1296:
According to a 2003 study, GBM prognosis can be divided into three subgroups dependent on KPS, the age of the patient, and treatment.
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Supportive treatment focuses on relieving symptoms and improving the patient's neurologic function. The primary supportive agents are
6380:"Brain Tumours: Rise in Glioblastoma Multiforme Incidence in England 1995–2015 Suggests an Adverse Environmental or Lifestyle Factor" 4532:"Isocitrate Dehydrogenase Mutations Are Associated with Different Expression and DNA Methylation Patterns of OLIG2 in Adult Gliomas" 6276:"University of California, Los Angeles Neuro-Oncology : How Our Patients Perform : Glioblastoma Multiforme [GBM]" 7642: 7566: 7490: 1265: 940: 744:
At least three distinct paths in the development of Glioblastomas have been identified with the aid of molecular investigations.
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Many other genetic alterations have been described in glioblastoma, and the majority of them are clustered in two pathways, the
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1 and is not mutated in glioblastoma. As such, these tumors behave more aggressively compared to IDH1-mutated astrocytomas.
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Increasing age (> 60 years) carries a worse prognostic risk. Death is usually due to widespread tumor infiltration with
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and glioblastoma, gliomas such as glioblastoma have long been assumed to originate from glial-type stem cells found in the
240:, and has a very poor prognosis for survival. Initial signs and symptoms of glioblastoma are nonspecific. They may include 6829:"Formulations for Intranasal Delivery of Pharmacological Agents to Combat Brain Disease: A New Opportunity to Tackle GBM?" 7328: 7182: 7101: 1172: 4298: 2665:"Detection of human herpesvirus-6 variants in pediatric brain tumors: association of viral antigen in low grade gliomas" 1071:
Treatment of primary brain tumors consists of palliative (symptomatic) care and therapies intended to improve survival.
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Tran B, Rosenthal MA (April 2010). "Survival comparison between glioblastoma multiforme and other incurable cancers".
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Other gene therapy approaches has also been explored in the context of glioblastoma, including suicide gene therapy.
1200:. Temozolomide seems to work by sensitizing the tumor cells to radiation, and appears more effective for tumors with 670: 930:, and other entities may have a similar appearance. Definitive diagnosis of a suspected GBM on CT or MRI requires a 767:
The second method involves activating the intracellular signaling system known as phosphatidylinositol-3-OH kinase (
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Smoll NR, Schaller K, Gautschi OP (May 2013). "Long-term survival of patients with glioblastoma multiforme (GBM)".
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are associated with longer survival. A DNA test can be conducted on glioblastomas to determine whether or not the
6726:"Suicide gene therapy for the treatment of high-grade glioma: past lessons, present trends, and future prospects" 458: 371: 5658:"Challenges in glioblastoma immunotherapy: mechanisms of resistance and therapeutic approaches to overcome them" 3945:
Gilbertson RJ, Rich JN (October 2007). "Making a tumour's bed: glioblastoma stem cells and the vascular niche".
1120: 7175: 927: 761: 6640:"Programming pluripotent precursor cells derived from Xenopus embryos to generate specific tissues and organs" 2931:
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There are currently three molecular subtypes of glioblastoma that were identified based on gene expression:
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shift: some of the tumors were defined also by their genetic composition as well as their cell morphology.
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Note: Not all brain tumors are of nervous tissue, and not all nervous tissue tumors are in the brain (see
4830:"Outcomes after combined use of intraoperative MRI and 5-aminolevulinic acid in high-grade glioma surgery" 1443:), and the highly variable appearance due to the presence of necrosis, hemorrhage, and cysts (multiform). 1246:
treatment, survival is typically three months. Complete cures are extremely rare, but have been reported.
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signaling in cultured glioma cells and that miRNA clustering controls epigenetic pathways in the disease.
4879:"DDRugging glioblastoma: understanding and targeting the DNA damage response to improve future therapies" 1501:. The results were encouraging and, as of 2016, a similar trial has been initiated in the United States. 947:
Distinguishing glioblastoma from high-grade astrocytoma is important. These tumors occur spontaneously (
2155:"Radiomic Analysis to Predict Histopathologically Confirmed Pseudoprogression in Glioblastoma Patients" 422: 4664:
Stevens GH (July 2006). "Antiepileptic therapy in patients with central nervous system malignancies".
4190:"MicroRNA-451 regulates LKB1/AMPK signaling and allows adaptation to metabolic stress in glioma cells" 3705:
Molenaar RJ, Verbaan D, Lamba S, Zanon C, Jeuken JW, Boots-Sprenger SH, et al. (September 2014).
3293:"The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary" 741:
Studies using genome-wide profiling have revealed glioblastomas to have a remarkable genetic variety.
7580: 6966:"Preclinical development and clinical use of perillyl alcohol for chemoprevention and cancer therapy" 4584: 768: 533: 3381:
Louis DN, Perry A, Wesseling P, Brat DJ, Cree IA, Figarella-Branger D, et al. (2 August 2021).
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for glioblastoma. GTV: gross tumor volume, CTV: clinical target volume, PTV: planning target volume.
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TERT promoter mutation, combined gain of chromosome 7 and loss of chromosome 10; EGFR amplification
374:. Previous radiation therapy is also a risk. For unknown reasons, it occurs more commonly in males. 7419: 7414: 7206: 7112: 2845:
Guyon J, Haidar Ahmad S, El Baba R, Le Quang M, Bikfalvi A, Daubon T, et al. (29 March 2024).
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3109:"Tumor Cell Infiltration into the Brain in Glioblastoma: From Mechanisms to Clinical Perspectives" 1212:
control symptoms, but do not appear to affect overall survival in those with glioblastoma. A 2018
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potentially removing disease before secondary resistance to radiotherapy and chemotherapy occurs.
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The third pathway is defined by p53 and retinoblastoma (Rb) tumor suppressor pathway inactivation.
413:(CMV). Infection with an oncogenic CMV may even be necessary for the development of glioblastoma. 7198: 5446: 2796:
El Baba R, Pasquereau S, Haidar Ahmad S, Monnien F, Abad M, Bibeau F, et al. (9 June 2023).
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Uncommon risk factors include genetic disorders such as neurofibromatosis, Li–Fraumeni syndrome,
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Stupp R, Taillibert S, Kanner AA, Kesari S, Steinberg DM, Toms SA, et al. (December 2015).
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Bleeker FE, Lamba S, Zanon C, Molenaar RJ, Hulsebos TJ, Troost D, et al. (September 2014).
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classification has been traditionally based on histopathology at macroscopic level, measured in
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2847:"Generation of glioblastoma in mice engrafted with human cytomegalovirus-infected astrocytes" 2569: 1480: 1254: 1134: 724: 430: 4928:"A systematic review of cognitive function in patients with glioblastoma undergoing surgery" 1821:
Ostrom QT, Cioffi G, Gittleman H, Patil N, Waite K, Kruchko C, et al. (November 2019).
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The mesenchymal subtype is characterized by high rates of mutations or other alterations in
7698: 7599: 7409: 6001:
Koshy M, Villano JL, Dolecek TA, Howard A, Mahmood U, Chmura SJ, et al. (March 2012).
4250: 1042: 898: 3567:
Verhaak RG, Hoadley KA, Purdom E, Wang V, Qi Y, Wilkerson MD, et al. (January 2010).
2495:
Smoll NR, Brady Z, Scurrah KJ, Lee C, Berrington de González A, Mathews JD (6 July 2023).
1225:
Phase 3 clinical trials of immunotherapy treatments for glioblastoma have largely failed.
41: 8: 7442: 7079: 5903:"Tumour treating fields therapy for glioblastoma: current advances and future directions" 4139:
Møller HG, Rasmussen AP, Andersen HH, Johnsen KB, Henriksen M, Duroux M (February 2013).
1097: 1046:
Management of IDH wild type glioblastoma, WHO grade 4. KPS, Karnofsky performance status.
931: 669:
in chromosome 10 is also frequently seen in the classical subtype alongside chromosome 7
478: 450: 406: 4507: 4482: 4254: 3904:
Murat A, Migliavacca E, Gorlia T, Lambiv WL, Shay T, Hamou MF, et al. (June 2008).
2873: 2846: 2822: 2798:"EZH2-Myc driven glioblastoma elicited by cytomegalovirus infection of human astrocytes" 2797: 2521: 2496: 2072: 1598: 1293:
UCLA Neuro-oncology publishes real-time survival data for patients with this diagnosis.
1187:
has been tested as an alternative treatment for glioblastoma, but is not in common use.
55:(viewed from the back of the head) with contrast of a glioblastoma in a 15-year-old male 7606: 7548: 7095: 7011: 6982: 6965: 6946: 6903: 6855: 6828: 6801: 6774: 6750: 6725: 6706: 6666: 6639: 6615: 6590: 6566: 6541: 6517: 6492: 6455: 6430: 6406: 6379: 6355: 6328: 6257: 6119: 6094: 6075: 6027: 6002: 5978: 5951: 5927: 5902: 5878: 5853: 5682: 5657: 5633: 5608: 5580: 5555: 5536: 5493: 5397: 5352: 5293: 5161:
Biegler KA, Chaoul MA, Cohen L (2009). "Cancer, cognitive impairment, and meditation".
5138: 5121: 5097: 5072: 5045: 5020: 4996: 4979: 4952: 4927: 4903: 4878: 4854: 4829: 4733: 4708: 4689: 4641: 4616: 4556: 4531: 4423: 4398: 4365: 4340: 4271: 4238: 4214: 4189: 4165: 4140: 4116: 4089: 4065: 4038: 4019: 3970: 3731: 3706: 3679: 3652: 3593: 3568: 3459: 3434: 3407: 3382: 3358: 3333: 3268: 3243: 3186: 3159: 3135: 3108: 3084: 3059: 3035: 3010: 2956: 2909: 2778: 2689: 2664: 2472: 2455: 2352: 2327: 2236: 2192: 2179: 2154: 2130: 2105: 2081: 2056: 2007: 1961: 1903: 1878: 1847: 1822: 1791: 1766: 1739: 1714: 1607: 1582: 1272: 474: 470: 367: 76: 6312: 6295: 4806: 2753:
McFaline-Figueroa JR, Wen PY (February 2017). "The Viral Connection to Glioblastoma".
2641: 2224: 7708: 7619: 7363: 7228: 7123: 7026: 6987: 6938: 6895: 6860: 6806: 6755: 6671: 6620: 6571: 6542:"The art of gene therapy for glioma: a review of the challenging road to the bedside" 6522: 6460: 6411: 6360: 6249: 6214: 6168: 6124: 6067: 6032: 5983: 5932: 5883: 5834: 5796: 5706:"FDA approves expanded indication for medical device to treat a form of brain cancer" 5687: 5638: 5585: 5528: 5485: 5389: 5328: 5285: 5249: 5214: 5178: 5143: 5102: 5050: 5001: 4957: 4908: 4859: 4810: 4774: 4738: 4681: 4646: 4561: 4512: 4463: 4428: 4370: 4321: 4276: 4219: 4170: 4121: 4070: 4023: 4011: 4001: 3962: 3927: 3884: 3853: 3818: 3777: 3736: 3684: 3633: 3598: 3546: 3505: 3464: 3412: 3363: 3314: 3273: 3222: 3191: 3140: 3089: 3060:"Cell of origin for malignant gliomas and its implication in therapeutic development" 3040: 2991: 2948: 2913: 2878: 2827: 2770: 2735: 2694: 2645: 2610: 2561: 2526: 2477: 2436: 2432: 2392: 2357: 2326:
Ostrom QT, Patil N, Cioffi G, Waite K, Kruchko C, Barnholtz-Sloan JS (October 2020).
2308: 2264: 2228: 2196: 2184: 2135: 2086: 2030: 1999: 1965: 1953: 1948: 1908: 1852: 1796: 1744: 1660: 1612: 1213: 1168: 792: 272: 264: 176: 137: 130: 122: 60: 7152: 7084: 6710: 6429:
Siegel DA, Li J, Henley SJ, Wilson RJ, Lunsford NB, Tai E, et al. (June 2018).
6294:
Shaw EG, Seiferheld W, Scott C, Coughlin C, Leibel S, Curran W, et al. (2003).
6261: 5540: 5401: 5297: 4693: 4615:
Lawson HC, Sampath P, Bohan E, Park MC, Hussain N, Olivi A, et al. (May 2007).
4341:"Normalizing tumor microenvironment to treat cancer: bench to bedside to biomarkers" 2987: 2960: 2782: 2240: 2106:"Exciting new advances in neuro-oncology: the avenue to a cure for malignant glioma" 727:. 68–78% and 88% of Glioblastomas have alterations in these pathways, respectively. 259:
The cause of most cases of glioblastoma is not known. Uncommon risk factors include
7671: 7437: 6977: 6950: 6930: 6907: 6887: 6850: 6840: 6796: 6786: 6745: 6737: 6698: 6661: 6651: 6610: 6602: 6561: 6553: 6512: 6504: 6491:
Rajesh Y, Pal I, Banik P, Chakraborty S, Borkar SA, Dey G, et al. (May 2017).
6450: 6442: 6401: 6391: 6350: 6340: 6307: 6241: 6204: 6158: 6114: 6106: 6079: 6059: 6022: 6014: 5973: 5963: 5922: 5914: 5873: 5865: 5826: 5786: 5677: 5669: 5628: 5624: 5620: 5609:"Treatment of newly diagnosed glioblastoma in the elderly: a network meta-analysis" 5575: 5571: 5567: 5520: 5497: 5477: 5424: 5379: 5320: 5277: 5241: 5206: 5170: 5133: 5092: 5084: 5040: 5032: 4991: 4947: 4939: 4898: 4890: 4849: 4841: 4802: 4766: 4728: 4720: 4673: 4636: 4628: 4551: 4543: 4502: 4494: 4455: 4418: 4410: 4360: 4352: 4313: 4266: 4258: 4209: 4201: 4160: 4152: 4111: 4101: 4060: 4050: 3993: 3974: 3954: 3917: 3876: 3845: 3808: 3769: 3726: 3718: 3674: 3664: 3625: 3588: 3580: 3536: 3495: 3454: 3446: 3402: 3394: 3353: 3345: 3304: 3263: 3255: 3214: 3181: 3171: 3130: 3120: 3106: 3079: 3071: 3030: 3022: 2983: 2940: 2905: 2868: 2858: 2817: 2809: 2762: 2725: 2684: 2676: 2637: 2600: 2553: 2516: 2508: 2467: 2428: 2384: 2347: 2339: 2300: 2220: 2174: 2166: 2153:
McKenney AS, Weg E, Bale TA, Wild AT, Um H, Fox MJ, et al. (6 February 2022).
2125: 2117: 2076: 2068: 2011: 1991: 1943: 1935: 1898: 1890: 1842: 1834: 1786: 1782: 1778: 1734: 1726: 1602: 1594: 1494: 862: 858: 462: 395: 260: 118: 7006: 5554:
Ameratunga M, Pavlakis N, Wheeler H, Grant R, Simes J, Khasraw M (November 2018).
5347: 5071:
Lange M, Joly F, Vardy J, Ahles T, Dubois M, Tron L, et al. (December 2019).
3011:"The cellular origin for malignant glioma and prospects for clinical advancements" 665:(p53), which is often mutated in glioblastoma, is rarely mutated in this subtype. 7703: 7511: 7355: 7117: 7033: 6891: 5245: 5036: 4205: 2573: 1518: 1428: 1328: 1261: 1180: 700: 510: 410: 253: 204: 192: 7167: 6656: 6110: 4399:"EANO guidelines on the diagnosis and treatment of diffuse gliomas of adulthood" 3997: 3992:. Advances in Experimental Medicine and Biology. Vol. 1139. pp. 1–21. 3773: 3450: 3383:"The 2021 WHO Classification of Tumors of the Central Nervous System: a summary" 3334:"The 2021 WHO Classification of Tumors of the Central Nervous System: a summary" 3218: 3160:"MRI evaluation of pathologies affecting the corpus callosum: A pictorial essay" 3075: 2557: 425:
is a risk factor. No risk had been confirmed as of 2003. Similarly, exposure to
7480: 7471: 7401: 7155: 7128: 6431:"Geographic Variation in Pediatric Cancer Incidence – United States, 2003–2014" 6063: 5918: 5673: 5210: 5021:"Prevalence, mechanisms, and management of cancer-related cognitive impairment" 4770: 4617:"Interstitial chemotherapy for malignant gliomas: the Johns Hopkins experience" 4414: 4262: 2863: 2813: 2388: 2170: 1995: 1583:"Current trends in the surgical management and treatment of adult glioblastoma" 1432: 1250: 1197: 1084: 1080: 1017: 1000: 442: 441:
The cellular origin of glioblastoma is unknown. Because of the similarities in
311: 65: 6934: 6245: 6018: 5524: 5481: 5428: 5174: 4677: 4632: 4156: 3584: 3309: 3292: 3259: 2944: 2766: 2680: 2304: 1894: 910: 298:
There is no known method of preventing the cancer. Treatment usually involves
7687: 7589: 7475: 7391: 6741: 6606: 6557: 6345: 4498: 4356: 3922: 3905: 3669: 3433:
Wang Q, Hu B, Hu X, Kim H, Squatrito M, Scarpace L, et al. (July 2017).
3398: 3349: 3176: 2512: 2343: 1108: 791:
Glioblastoma cells with properties similar to progenitor cells (glioblastoma
735: 292: 150: 49: 7069: 5968: 5869: 5830: 5791: 5774: 5443:"Temozolomide Plus Radiation Helps Brain Cancer – National Cancer Institute" 5088: 4894: 4845: 4724: 3722: 3125: 2730: 2713: 2605: 2588: 1838: 7626: 7614: 7286: 6991: 6942: 6899: 6864: 6845: 6810: 6759: 6702: 6675: 6624: 6575: 6526: 6464: 6446: 6415: 6396: 6364: 6253: 6218: 6209: 6192: 6172: 6128: 6071: 6036: 5987: 5936: 5887: 5838: 5800: 5691: 5642: 5589: 5532: 5489: 5393: 5332: 5253: 5182: 5147: 5106: 5054: 5005: 4961: 4912: 4863: 4814: 4778: 4742: 4685: 4650: 4565: 4547: 4516: 4467: 4432: 4374: 4325: 4280: 4223: 4174: 4125: 4074: 4055: 4015: 3966: 3931: 3857: 3822: 3781: 3758: 3740: 3688: 3637: 3602: 3550: 3509: 3468: 3416: 3367: 3318: 3277: 3195: 3144: 3093: 3044: 2995: 2952: 2917: 2882: 2831: 2774: 2739: 2712:
Chi J, Gu B, Zhang C, Peng G, Zhou F, Chen Y, et al. (November 2012).
2698: 2649: 2614: 2565: 2530: 2481: 2440: 2396: 2361: 2312: 2232: 2188: 2139: 2090: 2003: 1957: 1912: 1856: 1800: 1748: 1616: 1526: 1468: 1461: 1456: 1435:, based on the idea that the tumor originates from primitive precursors of 1161: 529: 426: 391: 307: 303: 188: 172: 69: 5368:"Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma" 5289: 4106: 3629: 3107:
Seker-Polat F, Pinarbasi Degirmenci N, Solaroglu I, Bagci-Onder T (2022).
2104:
Van Meir EG, Hadjipanayis CG, Norden AD, Shu HK, Wen PY, Olson JJ (2010).
748:
The first pathway involves the amplification and mutational activation of
647:
Classical: Around 97% of tumors in this subtype carry extra copies of the
7485: 7447: 7313: 7281: 7233: 6724:
Hossain JA, Marchini A, Fehse B, Bjerkvig R, Miletic H (1 January 2020).
6508: 5656:
Habashy KJ, Mansour R, Moussalem C, Sawaya R, Massaad MJ (October 2022).
5384: 5367: 5218: 4943: 4459: 3880: 3813: 3796: 2057:"Concurrent therapy to enhance radiotherapeutic outcomes in glioblastoma" 1919: 1268: 1209: 833: 525: 494: 482: 343: 276: 113: 4317: 3849: 1050:
Treating glioblastoma is difficult due to several complicating factors:
832:
Furthermore, GBM exhibits numerous alterations in genes that encode for
7630: 7543: 7386: 5324: 5281: 3541: 3524: 2121: 1939: 1730: 1531: 1436: 1412: 1283: 935: 923: 837: 805: 498: 486: 446: 319: 183: 7052: 6791: 6163: 6146: 5900: 3562: 3560: 3244:"The 2007 WHO classification of tumours of the central nervous system" 3026: 2662: 752:(RTK) genes, leading to the dysregulation of growth factor signaling. 7305: 7253: 7147: 6231: 5510: 3616:
Kuehn BM (March 2010). "Genomics illuminates a deadly brain cancer".
3158:
Kazi AZ, Joshi PC, Kelkar AB, Mahajan MS, Ghawate AS (October 2013).
1541: 1440: 1093: 561: 490: 454: 387: 280: 199: 3958: 3500: 3483: 2795: 7535: 7378: 3797:"MGMT gene silencing and benefit from temozolomide in glioblastoma" 3557: 1368:
Age ≥ 50, KPS ≥ 70, surgical removal with good neurologic function
1020:
of tumor cells, conferring a diagnosis of glioblastoma rather than
1016:
Lower magnification histopathology, showing necrosis surrounded by
506: 339: 335: 288: 241: 146: 82: 6775:"Oncolytic Viruses for Malignant Glioma: On the Verge of Success?" 6377: 3290: 1096:
concurrent with radiation may have serious skin reactions such as
7010:
for "Safety and Efficacy Study in Recurrent Grade IV Glioma " at
5467: 4396: 1498: 919: 890: 383: 299: 284: 168: 142: 7106: 5949: 4445: 3525:"Biomarkers and therapeutic advances in glioblastoma multiforme" 2844: 1879:"Recent advances in the molecular understanding of glioblastoma" 1167:
GBM tumors are well known to contain zones of tissue exhibiting
906:
with contrast of a glioblastoma WHO grade 4 in a 15-year-old boy
7463: 7296: 7064: 6826: 5266: 4791: 4039:"Chemotherapeutic Drugs: DNA Damage and Repair in Glioblastoma" 2497:"Computed tomography scan radiation and brain cancer incidence" 684: 514: 249: 245: 233: 90: 86: 7659:
WHO classification of the tumors of the central nervous system
5553: 5019:
Janelsins MC, Kesler SR, Ahles TA, Morrow GR (February 2014).
4755: 4138: 3209:
Kleihues P, Burger PC, Scheithauer BW (1993). "Introduction".
2714:"Human herpesvirus 6 latent infection in patients with glioma" 2627: 963:, whereas this mutation is not present in glioblastoma. Thus, 6300:
International Journal of Radiation Oncology, Biology, Physics
6190: 5655: 5606: 5234:
International Journal of Radiation Oncology, Biology, Physics
5122:"Cognitive Impairment Associated with Cancer: A Brief Review" 4980:"Cognitive Impairment Associated with Cancer: A Brief Review" 4299:"The glioblastoma vasculature as a target for cancer therapy" 4236: 2103: 1765:
Hart MG, Garside R, Rogers G, Stein K, Grant R (April 2013).
1057:
The brain is susceptible to damage from conventional therapy.
974: 841: 796: 676:
The proneural subtype often has high rates of alterations in
237: 6723: 5364: 5231: 4187: 3987: 3903: 3211:
Histological Typing of Tumours of the Central Nervous System
2291:
McNeill KA (November 2016). "Epidemiology of Brain Tumors".
6293: 5952:"Epidemiology of Glioblastoma Multiforme-Literature Review" 5772: 5195: 2973: 2898:
Journal of Environmental Pathology, Toxicology and Oncology
1279: 984: 980: 959: 953: 866: 800: 776: 661: 402: 5310: 5018: 3241: 2209: 1820: 6490: 6000: 5417:
Progress in Neurotherapeutics and Neuropsychopharmacology
5119: 4977: 4827: 3835: 3704: 3650: 3208: 2895: 1580: 903: 772: 678: 52: 6920: 6540:
Tobias A, Ahmed A, Moon KS, Lesniak MS (February 2013).
6186: 6184: 6182: 5120:
Pendergrass JC, Targum SD, Harrison JE (February 2018).
4978:
Pendergrass JC, Targum SD, Harrison JE (February 2018).
3566: 2543: 1054:
The tumor cells are resistant to conventional therapies.
318:
the brain and the second-most common brain tumor, after
283:. The diagnosis typically is made by a combination of a 6378:
Philips A, Henshaw DL, Lamburn G, O'Carroll MJ (2018).
6284:. Neurooncology.ucla.edu. Retrieved on 19 October 2010. 4036: 3794: 3762:
Biochimica et Biophysica Acta (BBA) – Reviews on Cancer
3380: 3331: 1876: 1581:
Young RM, Jamshidi A, Davis G, Sherman JH (June 2015).
1133:
if the surgery is guided by a fluorescent dye known as
655:) gene, and most have higher than normal expression of 6539: 4707:
Das S, Marsden PA (October 2013). Phimister EG (ed.).
4614: 4529: 3157: 2456:"Current data and strategy in glioblastoma multiforme" 2374: 2325: 1925: 1764: 481:(CSF) (> 100 mg/dl), as well as an occasional 310:
is frequently used as part of chemotherapy. High-dose
6179: 6144: 6092: 6049: 4530:
Mo H, Magaki S, Deisch JK, Raghavan R (August 2022).
2930: 7042: 6963: 6428: 6093:
Caruso R, Pesce A, Wierzbicki V (20 February 2017).
5854:"TTFields: where does all the skepticism come from?" 5730: 5414: 4925: 4536:
Journal of Neuropathology and Experimental Neurology
2752: 2593:
Journal of Neuropathology and Experimental Neurology
2494: 1508: 509:
and may exhibit the classic infiltration across the
493:
cells carried in the CSF may spread (rarely) to the
252:. Symptoms often worsen rapidly and may progress to 207:~ 12 months with treatment (5 year survival <10%) 5070: 4973: 4971: 2152: 1124:
Glioblastoma pre (left) and post (right) resection.
616:Usually supratentorial, rarely cerebellum or spine 6772: 6546:Journal of Neurology, Neurosurgery, and Psychiatry 5160: 1060:The brain has a limited capacity to repair itself. 401:Glioblastoma has been associated with the viruses 232:), is the most aggressive and most common type of 7197: 6877: 6193:"Long-term survival with glioblastoma multiforme" 5113: 3653:"Mutational profiling of kinases in glioblastoma" 3008: 2418: 1715:"Nonsurgical treatment of recurrent glioblastoma" 779:, which is crucial for controlling cell survival. 7685: 6140: 6138: 5738:"FDA approval letter â€“ NovoTTF-100A System" 4968: 1877:Bleeker FE, Molenaar RJ, Leenstra S (May 2012). 1183:, and as of 2015 a clinical trial was underway. 894:GBM in the frontal right lobe as seen on CT scan 421:Research has been done to see if consumption of 5556:"Anti-angiogenic therapy for high-grade glioma" 4926:Sinha R, Stephenson JM, Price SJ (March 2020). 4292: 4290: 3522: 3057: 1650: 1648: 1646: 983:expression, immunohistochemical negativity for 730:Another important alteration is methylation of 584:Median length of clinical history at diagnosis 306:and radiation therapy are used. The medication 6822: 6820: 6637: 6147:"The cure fraction of glioblastoma multiforme" 5812: 5810: 5012: 4876: 4480: 4037:Annovazzi L, Mellai M, Schiffer D (May 2017). 3944: 3523:Sasmita AO, Wong YP, Ling AP (February 2018). 2711: 2586: 2263:. Philadelphia: Mosby Elsevier. p. 1336. 1644: 1642: 1640: 1638: 1636: 1634: 1632: 1630: 1628: 1626: 545:Features of glioblastoma, IDH wildtype, WHO 4 520: 7183: 6591:"The status of gene therapy for brain tumors" 6135: 6099:International Journal of Surgery Case Reports 5066: 5064: 4392: 4390: 4388: 4386: 4384: 3754: 3752: 3750: 3700: 3698: 3164:The Indian Journal of Radiology & Imaging 1981: 1092:prescribing this medication. Those receiving 477:wall, leading to high protein content in the 6588: 5154: 4608: 4287: 3516: 3058:Zong H, Parada LF, Baker SJ (January 2015). 473:. The tumor may extend into the meninges or 7522:Embryonal tumour with multilayered rosettes 6817: 6435:MMWR. Morbidity and Mortality Weekly Report 6326: 5807: 5613:The Cochrane Database of Systematic Reviews 5560:The Cochrane Database of Systematic Reviews 3432: 1977: 1975: 1771:The Cochrane Database of Systematic Reviews 1623: 1576: 1574: 1572: 1570: 1568: 1566: 1564: 1562: 1487: 756:(EGF), vascular endothelial growth factor ( 7190: 7176: 6964:Chen TC, Fonseca CO, Schönthal AH (2015). 6384:Journal of Environmental and Public Health 6145:Smoll NR, Schaller K, Gautschi OP (2012). 5061: 4919: 4706: 4666:Current Neurology and Neuroscience Reports 4487:Exploration of Targeted Anti-Tumor Therapy 4381: 3747: 3695: 3064:Cold Spring Harbor Perspectives in Biology 2453: 2252: 2250: 2018: 1760: 1758: 1708: 1706: 1704: 1702: 1700: 1698: 1696: 40: 6981: 6854: 6844: 6800: 6790: 6749: 6688: 6665: 6655: 6614: 6565: 6516: 6454: 6405: 6395: 6354: 6344: 6311: 6208: 6162: 6118: 6026: 5977: 5967: 5926: 5877: 5790: 5766: 5681: 5632: 5579: 5383: 5137: 5096: 5044: 4995: 4951: 4902: 4853: 4732: 4640: 4555: 4506: 4422: 4364: 4270: 4213: 4164: 4115: 4105: 4064: 4054: 3921: 3870: 3812: 3730: 3678: 3668: 3592: 3540: 3529:Asia-Pacific Journal of Clinical Oncology 3499: 3458: 3406: 3357: 3308: 3267: 3185: 3175: 3134: 3124: 3083: 3051: 3034: 3009:Zong H, Verhaak RG, Canoll P (May 2012). 3002: 2872: 2862: 2821: 2729: 2688: 2604: 2520: 2471: 2414: 2412: 2410: 2408: 2406: 2351: 2286: 2284: 2178: 2129: 2080: 1947: 1902: 1872: 1870: 1868: 1866: 1846: 1790: 1738: 1694: 1692: 1690: 1688: 1686: 1684: 1682: 1680: 1678: 1676: 1606: 621:Necrosis and microvascular proliferation 497:or cause meningeal gliomatosis. However, 6773:Suryawanshi YR, Schulze AJ (July 2021). 5547: 4087: 2256: 1972: 1816: 1814: 1812: 1810: 1559: 1475: 1460:LPLNP-PPT (long persistent luminescence 1148: 1119: 1041: 909: 897: 889: 638: 7643:Malignant peripheral nerve sheath tumor 7567:Primary central nervous system lymphoma 7491:Dysembryoplastic neuroepithelial tumour 5816: 4663: 4481:Eibl RH, Schneemann M (February 2023). 4296: 2290: 2247: 2050: 2048: 2046: 1755: 1712: 1376:Age ≥ 50, KPS ≥ 70, no surgical removal 914:Diagnostic algorithm of diffuse glioma. 760:), and platelet-derived growth factor ( 690:platelet-derived growth factor receptor 629:Associated molecular/genetic mutations 465:could all serve as the cell of origin. 382:Other associations include exposure to 7686: 6638:Borchers A, Pieler T (November 2010). 5754:from the original on 22 September 2015 4877:Rominiyi O, Collis SJ (January 2022). 3481: 3015:Expert Review of Molecular Diagnostics 2537: 2488: 2454:Iacob G, Dinca EB (25 November 2009). 2403: 2281: 2054: 1863: 1673: 1074: 605:Surgery + radiotherapy + chemotherapy 7171: 6589:Fulci G, Chiocca EA (February 2007). 3615: 3428: 3426: 1807: 882:processes such as immunosuppression. 591: 329: 275:. Glioblastomas represent 15% of all 248:, and symptoms similar to those of a 6595:Expert Opinion on Biological Therapy 6481:. JB Lippincott, Philadelphia, 1926. 5851: 5126:Innovations in Clinical Neuroscience 4984:Innovations in Clinical Neuroscience 4338: 2043: 1767:"Temozolomide for high grade glioma" 876: 786: 513:, producing a butterfly (bilateral) 7329:Subependymal giant cell astrocytoma 6970:American Journal of Cancer Research 5649: 5372:The New England Journal of Medicine 4713:The New England Journal of Medicine 4596:from the original on 9 October 2021 3801:The New England Journal of Medicine 3484:"Genomics boosts brain-cancer work" 2260:Neurology and clinical neuroscience 2073:10.3978/j.issn.2305-5839.2016.01.25 2029:. World Health Organization. 2014. 1659:. World Health Organization. 2014. 1599:10.3978/j.issn.2305-5839.2015.05.10 1228: 1173:oxygen diffusion-enhancing compound 453:. More recent studies suggest that 350:until it reaches an enormous size. 13: 6327:Xu H, Chen J, Xu H, Qin Z (2017). 5718:from the original on 23 March 2016 5025:International Review of Psychiatry 3990:Stem Cells Heterogeneity in Cancer 3423: 2910:10.1615/JEnvPathToxOncol.v22.i2.60 2755:Current Infectious Disease Reports 2718:The Journal of Infectious Diseases 2587:Ohgaki H, Kleihues P (June 2005). 2277:from the original on 29 July 2017. 1234:Alternating electric field therapy 14: 7720: 7020: 4403:Nature Reviews. Clinical Oncology 279:. They are thought to arise from 7517:Atypical teratoid rhabdoid tumor 7038:American Brain Tumor Association 6998: 6957: 6914: 6871: 6766: 6717: 6682: 6631: 6582: 6533: 6484: 6471: 6422: 6371: 6320: 6287: 6268: 6225: 6086: 6052:Journal of Clinical Neuroscience 6043: 5994: 4483:"Liquid biopsy and glioblastoma" 4306:Biochemical Society Transactions 2630:The American Journal of Medicine 2433:10.1016/j.pharmthera.2015.05.005 2061:Annals of Translational Medicine 1984:Journal of Clinical Neuroscience 1587:Annals of Translational Medicine 1547:List of people with brain tumors 1511: 1220: 1009: 993: 649:epidermal growth factor receptor 459:oligodendrocyte progenitor cells 377: 6880:Expert Opinion on Drug Delivery 6333:Frontiers in Aging Neuroscience 5943: 5894: 5845: 5698: 5600: 5504: 5461: 5435: 5408: 5358: 5339: 5304: 5260: 5225: 5189: 4870: 4821: 4785: 4749: 4700: 4657: 4572: 4523: 4474: 4439: 4332: 4230: 4181: 4132: 4081: 4030: 3981: 3938: 3897: 3864: 3829: 3788: 3644: 3609: 3475: 3374: 3325: 3284: 3235: 3202: 3151: 3100: 2988:10.1016/j.pathophys.2009.01.003 2967: 2924: 2889: 2838: 2789: 2746: 2705: 2656: 2621: 2580: 2447: 2421:Pharmacology & Therapeutics 2368: 2319: 2203: 2146: 2097: 1451: 1399: 1310:Historical Median Survival Time 1302:Recursive partitioning analysis 1190: 1144: 827: 436: 353: 16:Aggressive type of brain cancer 7611:Cranial and paraspinal nerves 7027:Information about glioblastoma 5625:10.1002/14651858.cd013261.pub2 5572:10.1002/14651858.CD008218.pub4 4709:"Angiogenesis in glioblastoma" 4090:"Ion channels in glioblastoma" 2159:Advances in Radiation Oncology 1783:10.1002/14651858.CD007415.pub2 1497:for intranasal delivery as an 928:tumefactive multiple sclerosis 1: 7324:Pleomorphic xanthoastrocytoma 7199:Tumours of the nervous system 6691:Advanced Functional Materials 6313:10.1016/S0360-3016(03)00843-5 4807:10.1016/S1470-2045(06)70665-9 2642:10.1016/S0002-9343(03)00087-1 2225:10.1016/S1470-2045(09)70025-7 1552: 1407:It is the second-most common 1185:Boron neutron capture therapy 1028: 811: 703:and fewer alterations in the 7369:Anaplastic oligodendroglioma 6892:10.1517/17425247.2013.790887 5711:Food and Drug Administration 5246:10.1016/j.ijrobp.2007.03.045 5037:10.3109/09540261.2013.864260 4345:Journal of Clinical Oncology 4206:10.1016/j.molcel.2010.02.018 3910:Journal of Clinical Oncology 2669:Journal of Clinical Virology 2460:Journal of Medicine and Life 1240: 1154:Radiation treatment planning 1063:Many drugs cannot cross the 1037: 885: 836:, including upregulation of 820:gene encodes for the enzyme 707:gene and less expression of 7: 6657:10.3390/chemosensors8040117 6111:10.1016/j.ijscr.2017.02.025 4297:Dimberg A (December 2014). 3998:10.1007/978-3-030-14366-4_1 3774:10.1016/j.bbcan.2014.05.004 3451:10.1016/j.ccell.2017.06.003 3219:10.1007/978-3-642-84988-6_1 3076:10.1101/cshperspect.a020610 2558:10.1016/j.canep.2016.03.006 1504: 1446: 1319:Historical 5-Year Survival 1262:Karnofsky performance score 852: 521:Glioblastoma classification 485:of 10 to 100 cells, mostly 361: 10: 7725: 6497:Acta Pharmacologica Sinica 6479:Tumors of the Glioma Group 6064:10.1016/j.jocn.2012.05.040 5919:10.1038/s41416-020-01136-5 5674:10.1038/s41416-022-01864-w 5355:, accessed 1 February 2016 5211:10.3171/jns.1978.49.3.0333 4771:10.3171/jns.2001.95.2.0190 4415:10.1038/s41571-020-00447-z 4263:10.1038/s41467-019-08390-z 3482:Hayden EC (January 2010). 2864:10.1038/s41417-024-00767-7 2814:10.1038/s41388-023-02709-3 2389:10.1016/j.ejca.2015.07.032 2377:European Journal of Cancer 2171:10.1016/j.adro.2022.100916 2055:Khosla D (February 2016). 1996:10.1016/j.jocn.2009.09.004 1427:was introduced in 1926 by 1418: 1316:Historical 3-Year Survival 1313:Historical 1-Year Survival 1115: 7694:Aging-associated diseases 7667: 7651: 7579: 7557: 7534: 7504: 7460: 7430: 7400: 7377: 7354: 7304: 7295: 7275: 7266: 7242: 7214: 7205: 7138: 7046: 6935:10.1007/s11060-013-1346-5 6923:Journal of Neuro-Oncology 6246:10.1007/s11060-006-9292-0 6234:Journal of Neuro-Oncology 6019:10.1007/s11060-011-0738-7 6007:Journal of Neuro-Oncology 5907:British Journal of Cancer 5662:British Journal of Cancer 5525:10.1007/s11060-008-9663-9 5513:Journal of Neuro-Oncology 5482:10.1007/s11060-006-9241-y 5470:Journal of Neuro-Oncology 5429:10.1017/S1748232105000054 5270:Journal of Neuro-Oncology 5175:10.1080/02841860802415535 4678:10.1007/s11910-006-0024-9 4633:10.1007/s11060-006-9303-1 4621:Journal of Neuro-Oncology 4585:The James Cancer Hospital 4157:10.1007/s12035-012-8349-7 3585:10.1016/j.ccr.2009.12.020 3310:10.1007/s00401-016-1545-1 3260:10.1007/s00401-007-0243-4 2945:10.1007/s11060-007-9432-1 2933:Journal of Neuro-Oncology 2767:10.1007/s11908-017-0563-z 2681:10.1016/j.jcv.2009.05.011 2305:10.1016/j.ncl.2016.06.014 1895:10.1007/s11060-011-0793-0 1883:Journal of Neuro-Oncology 1713:Gallego O (August 2015). 1387: 1384: 1381: 1378: 1372: 1362: 1359: 1356: 1353: 1347: 1208:with medications such as 1107:Corticosteroids, usually 688:the gene encoding a-type 534:World Health Organization 211: 198: 182: 164: 156: 136: 112: 104: 96: 75: 59: 48: 39: 31: 26: 7496:Lhermitte–Duclos disease 7420:Choroid plexus carcinoma 7415:Choroid plexus papilloma 6607:10.1517/14712598.7.2.197 6558:10.1136/jnnp-2012-302946 6346:10.3389/fnagi.2017.00352 4499:10.37349/etat.2023.00121 4357:10.1200/JCO.2012.46.3653 3923:10.1200/JCO.2007.15.7164 3873:Handbook of Neurosurgery 3670:10.1186/1471-2407-14-718 3177:10.4103/0971-3026.125604 2338:(12 Suppl 2): iv1–iv96. 2027:World Cancer Report 2014 1657:World Cancer Report 2014 1488:Intranasal drug delivery 1351:Age < 50, KPS < 90 1177:trans sodium crocetinate 1102:Stevens–Johnson syndrome 822:isocitrate dehydrogenase 754:Epithelial growth factor 750:receptor tyrosine kinase 592:Median overall survival 568:Median age at diagnosis 416: 338:, headaches, nausea and 334:Common symptoms include 89:, symptoms similar to a 7032:5 February 2024 at the 6730:Neuro-Oncology Advances 6650:(3). MDPI AG: 413–426. 5969:10.3390/cancers14102412 5831:10.1001/jama.2015.16701 5792:10.1001/jama.2015.16669 5199:Journal of Neurosurgery 4932:Neuro-Oncology Practice 4895:10.1002/1878-0261.13020 4759:Journal of Neurosurgery 4725:10.1056/NEJMcibr1309402 3838:Genes & Development 3126:10.3390/cancers14020443 1537:Glioblastoma Foundation 1425:glioblastoma multiforme 842:ClC-3 chloride channels 597:Surgery + radiotherapy 244:, personality changes, 236:that originates in the 226:glioblastoma multiforme 85:, personality changes, 81:Initially nonspecific, 35:Glioblastoma multiforme 7339:Anaplastic astrocytoma 7334:Fibrillary astrocytoma 7004:Clinical trial number 6846:10.3390/cancers5031020 6742:10.1093/noajnl/vdaa013 6703:10.1002/adfm.201604992 6477:Bailey & Cushing: 6447:10.15585/mmwr.mm6725a2 5345:Clinical trial number 4145:Molecular Neurobiology 4056:10.3390/cancers9060057 3947:Nature Reviews. Cancer 3399:10.1093/neuonc/noab106 3350:10.1093/neuonc/noab106 2513:10.1093/neuonc/noad012 2344:10.1093/neuonc/noaa200 1409:central nervous system 1393:Age ≥ 50, KPS < 70 1206:Antiangiogenic therapy 1157: 1125: 1047: 1022:anaplastic astrocytoma 915: 907: 895: 865:is a key regulator of 838:gBK potassium channels 667:Loss of heterozygosity 503:central nervous system 431:electromagnetic fields 348:asymptomatic condition 224:, previously known as 215:3 per 100,000 per year 7595:Esthesioneuroblastoma 7319:Pilocytic astrocytoma 5870:10.1093/neuonc/now012 5852:Wick W (March 2016). 5089:10.1093/annonc/mdz410 4846:10.1093/neuonc/nov049 4590:Ohio State University 4339:Jain RK (June 2013). 4243:Nature Communications 3871:Greenberg MS (2016). 3723:10.1093/neuonc/nou005 3630:10.1001/jama.2010.236 3297:Acta Neuropathologica 3248:Acta Neuropathologica 2731:10.1093/infdis/jis513 2606:10.1093/jnen/64.6.479 1949:10536/DRO/DU:30138185 1934:(4). Wiley: 299–312. 1839:10.1093/neuonc/noz150 1481:Oncolytic virotherapy 1476:Oncolytic virotherapy 1255:intracranial pressure 1152: 1135:5-aminolevulinic acid 1123: 1045: 913: 901: 893: 639:Molecular alterations 7600:Ganglioneuroblastoma 7505:CNS embryonal tumors 7410:Choroid plexus tumor 6509:10.1038/aps.2016.167 6397:10.1155/2018/7910754 6210:10.1093/brain/awm204 6203:(Pt 10): 2596–2606. 5385:10.1056/NEJMoa043330 4795:The Lancet. Oncology 4580:"Gliomas Prevention" 4548:10.1093/jnen/nlac059 4460:10.1148/rg.272065155 4088:Molenaar RJ (2011). 3881:10.1055/b-006-149702 3814:10.1056/NEJMoa043331 2257:Schapira AH (2007). 2213:The Lancet. Oncology 1833:(Suppl 5): v1–v100. 1217:radiotherapy alone. 1067:to act on the tumor. 699:, the gene encoding 396:rubber manufacturing 269:Li–Fraumeni syndrome 127:Li–Fraumeni syndrome 7443:Gliomatosis cerebri 4318:10.1042/BST20140278 4255:2019NatCo..10..442B 4107:10.5402/2011/590249 3850:10.1101/gad.1596707 2851:Cancer Gene Therapy 2546:Cancer Epidemiology 1098:erythema multiforme 1075:Symptomatic therapy 1065:blood–brain barrier 932:stereotactic biopsy 806:DNA damage response 546: 479:cerebrospinal fluid 451:subventricular zone 7607:Nerve sheath tumor 7549:Hemangiopericytoma 7139:External resources 7012:ClinicalTrials.gov 5353:ClinicalTrials.gov 5325:10.2217/fon.10.123 5282:10.1007/BF00170946 5077:Annals of Oncology 4944:10.1093/nop/npz018 4883:Molecular Oncology 3542:10.1111/ajco.12756 2293:Neurologic Clinics 2122:10.3322/caac.20069 1940:10.3322/caac.21613 1731:10.3747/co.22.2436 1484:overall survival. 1158: 1126: 1048: 916: 908: 896: 736:MGMT gene promoter 659:, whereas the gene 576:Male:Female ratio 553:Glioblastoma, GBM 544: 501:of GBM beyond the 471:perivascular space 429:, and residential 392:petroleum refining 368:tuberous sclerosis 330:Signs and symptoms 7681: 7680: 7620:Neurofibromatosis 7575: 7574: 7530: 7529: 7456: 7455: 7364:Oligodendroglioma 7262: 7261: 7229:Craniopharyngioma 7165: 7164: 6792:10.3390/v13071294 6164:10.1159/000339319 6151:Neuroepidemiology 5825:(23): 2511–2513. 5785:(23): 2535–2543. 5449:on 15 August 2007 5319:(10): 1591–1601. 5083:(12): 1925–1940. 4840:(12): 1560–1567. 4719:(16): 1561–1563. 4351:(17): 2205–2218. 4007:978-3-030-14365-7 3916:(18): 3015–3024. 3890:978-1-62623-242-6 3844:(21): 2683–2710. 3228:978-3-540-56971-8 3027:10.1586/erm.12.30 2808:(24): 2031–2045. 2383:(15): 2231–2241. 2270:978-0-323-07053-9 2036:978-92-832-0429-9 1666:978-92-832-0429-9 1397: 1396: 1214:systematic review 877:Tumor vasculature 793:cancer stem cells 787:Cancer stem cells 711:than other types. 636: 635: 530:hematoxylin-eosin 463:neural stem cells 390:, and working in 273:radiation therapy 265:neurofibromatosis 261:genetic disorders 219: 218: 138:Diagnostic method 131:radiation therapy 123:neurofibromatosis 119:Genetic disorders 21:Medical condition 7716: 7672:brain metastasis 7636:Acoustic neuroma 7438:Oligoastrocytoma 7431:Multiple/unknown 7302: 7301: 7293: 7292: 7273: 7272: 7247: 7222: 7212: 7211: 7192: 7185: 7178: 7169: 7168: 7044: 7043: 7014: 7002: 6996: 6995: 6985: 6976:(5): 1580–1593. 6961: 6955: 6954: 6918: 6912: 6911: 6875: 6869: 6868: 6858: 6848: 6839:(3): 1020–1048. 6824: 6815: 6814: 6804: 6794: 6770: 6764: 6763: 6753: 6721: 6715: 6714: 6686: 6680: 6679: 6669: 6659: 6635: 6629: 6628: 6618: 6586: 6580: 6579: 6569: 6537: 6531: 6530: 6520: 6488: 6482: 6475: 6469: 6468: 6458: 6426: 6420: 6419: 6409: 6399: 6375: 6369: 6368: 6358: 6348: 6324: 6318: 6317: 6315: 6291: 6285: 6283: 6278:. Archived from 6272: 6266: 6265: 6229: 6223: 6222: 6212: 6188: 6177: 6176: 6166: 6142: 6133: 6132: 6122: 6090: 6084: 6083: 6047: 6041: 6040: 6030: 5998: 5992: 5991: 5981: 5971: 5947: 5941: 5940: 5930: 5898: 5892: 5891: 5881: 5849: 5843: 5842: 5814: 5805: 5804: 5794: 5770: 5764: 5763: 5761: 5759: 5753: 5742: 5734: 5728: 5727: 5725: 5723: 5702: 5696: 5695: 5685: 5653: 5647: 5646: 5636: 5604: 5598: 5597: 5583: 5566:(11): CD008218. 5551: 5545: 5544: 5508: 5502: 5501: 5465: 5459: 5458: 5456: 5454: 5445:. Archived from 5439: 5433: 5432: 5412: 5406: 5405: 5387: 5362: 5356: 5343: 5337: 5336: 5308: 5302: 5301: 5264: 5258: 5257: 5229: 5223: 5222: 5193: 5187: 5186: 5158: 5152: 5151: 5141: 5117: 5111: 5110: 5100: 5068: 5059: 5058: 5048: 5016: 5010: 5009: 4999: 4975: 4966: 4965: 4955: 4923: 4917: 4916: 4906: 4874: 4868: 4867: 4857: 4825: 4819: 4818: 4789: 4783: 4782: 4753: 4747: 4746: 4736: 4704: 4698: 4697: 4661: 4655: 4654: 4644: 4612: 4606: 4605: 4603: 4601: 4576: 4570: 4569: 4559: 4527: 4521: 4520: 4510: 4478: 4472: 4471: 4443: 4437: 4436: 4426: 4394: 4379: 4378: 4368: 4336: 4330: 4329: 4312:(6): 1647–1652. 4303: 4294: 4285: 4284: 4274: 4234: 4228: 4227: 4217: 4185: 4179: 4178: 4168: 4136: 4130: 4129: 4119: 4109: 4085: 4079: 4078: 4068: 4058: 4034: 4028: 4027: 3985: 3979: 3978: 3942: 3936: 3935: 3925: 3901: 3895: 3894: 3868: 3862: 3861: 3833: 3827: 3826: 3816: 3807:(10): 997–1003. 3792: 3786: 3785: 3756: 3745: 3744: 3734: 3717:(9): 1263–1273. 3702: 3693: 3692: 3682: 3672: 3648: 3642: 3641: 3613: 3607: 3606: 3596: 3564: 3555: 3554: 3544: 3520: 3514: 3513: 3503: 3479: 3473: 3472: 3462: 3430: 3421: 3420: 3410: 3393:(8): 1231–1251. 3378: 3372: 3371: 3361: 3344:(8): 1231–1251. 3329: 3323: 3322: 3312: 3288: 3282: 3281: 3271: 3239: 3233: 3232: 3213:. pp. 1–3. 3206: 3200: 3199: 3189: 3179: 3155: 3149: 3148: 3138: 3128: 3104: 3098: 3097: 3087: 3055: 3049: 3048: 3038: 3006: 3000: 2999: 2982:(2–3): 113–122. 2971: 2965: 2964: 2928: 2922: 2921: 2893: 2887: 2886: 2876: 2866: 2857:(7): 1070–1080. 2842: 2836: 2835: 2825: 2793: 2787: 2786: 2750: 2744: 2743: 2733: 2724:(9): 1394–1398. 2709: 2703: 2702: 2692: 2660: 2654: 2653: 2625: 2619: 2618: 2608: 2584: 2578: 2577: 2541: 2535: 2534: 2524: 2507:(7): 1368–1376. 2492: 2486: 2485: 2475: 2451: 2445: 2444: 2416: 2401: 2400: 2372: 2366: 2365: 2355: 2323: 2317: 2316: 2288: 2279: 2278: 2254: 2245: 2244: 2207: 2201: 2200: 2182: 2150: 2144: 2143: 2133: 2101: 2095: 2094: 2084: 2052: 2041: 2040: 2022: 2016: 2015: 1979: 1970: 1969: 1951: 1923: 1917: 1916: 1906: 1874: 1861: 1860: 1850: 1818: 1805: 1804: 1794: 1762: 1753: 1752: 1742: 1725:(4): e273–e281. 1719:Current Oncology 1710: 1671: 1670: 1655:"Chapter 5.16". 1652: 1621: 1620: 1610: 1578: 1521: 1516: 1515: 1514: 1495:perillyl alcohol 1299: 1298: 1229:Other procedures 1181:radiosensitizers 1013: 997: 859:RNA interference 547: 543: 44: 24: 23: 7724: 7723: 7719: 7718: 7717: 7715: 7714: 7713: 7684: 7683: 7682: 7677: 7676: 7663: 7647: 7571: 7553: 7526: 7512:Medulloblastoma 7500: 7462: 7452: 7426: 7396: 7373: 7356:Oligodendrocyte 7350: 7285: 7279: 7277:Neuroepithelial 7258: 7243: 7238: 7215: 7201: 7196: 7166: 7161: 7160: 7134: 7133: 7055: 7034:Wayback Machine 7023: 7018: 7017: 7003: 6999: 6962: 6958: 6919: 6915: 6876: 6872: 6825: 6818: 6771: 6767: 6722: 6718: 6697:(11): 1604992. 6687: 6683: 6636: 6632: 6587: 6583: 6538: 6534: 6489: 6485: 6476: 6472: 6441:(25): 707–713. 6427: 6423: 6376: 6372: 6325: 6321: 6292: 6288: 6282:on 9 June 2012. 6274: 6273: 6269: 6230: 6226: 6189: 6180: 6143: 6136: 6091: 6087: 6048: 6044: 5999: 5995: 5948: 5944: 5899: 5895: 5850: 5846: 5815: 5808: 5771: 5767: 5757: 5755: 5751: 5740: 5736: 5735: 5731: 5721: 5719: 5704: 5703: 5699: 5654: 5650: 5619:(3): CD013261. 5605: 5601: 5552: 5548: 5509: 5505: 5466: 5462: 5452: 5450: 5441: 5440: 5436: 5413: 5409: 5378:(10): 987–996. 5363: 5359: 5344: 5340: 5313:Future Oncology 5309: 5305: 5265: 5261: 5230: 5226: 5194: 5190: 5163:Acta Oncologica 5159: 5155: 5118: 5114: 5069: 5062: 5017: 5013: 4976: 4969: 4924: 4920: 4875: 4871: 4826: 4822: 4790: 4786: 4754: 4750: 4705: 4701: 4662: 4658: 4613: 4609: 4599: 4597: 4578: 4577: 4573: 4528: 4524: 4479: 4475: 4444: 4440: 4395: 4382: 4337: 4333: 4301: 4295: 4288: 4235: 4231: 4186: 4182: 4137: 4133: 4086: 4082: 4035: 4031: 4008: 3986: 3982: 3959:10.1038/nrc2246 3953:(10): 733–736. 3943: 3939: 3902: 3898: 3891: 3869: 3865: 3834: 3830: 3793: 3789: 3757: 3748: 3703: 3696: 3649: 3645: 3624:(10): 925–927. 3614: 3610: 3565: 3558: 3521: 3517: 3501:10.1038/463278a 3480: 3476: 3445:(1): 42–56.e6. 3431: 3424: 3379: 3375: 3330: 3326: 3289: 3285: 3240: 3236: 3229: 3207: 3203: 3156: 3152: 3105: 3101: 3056: 3052: 3007: 3003: 2976:Pathophysiology 2972: 2968: 2929: 2925: 2894: 2890: 2843: 2839: 2794: 2790: 2751: 2747: 2710: 2706: 2661: 2657: 2626: 2622: 2585: 2581: 2542: 2538: 2493: 2489: 2452: 2448: 2417: 2404: 2373: 2369: 2324: 2320: 2289: 2282: 2271: 2255: 2248: 2208: 2204: 2151: 2147: 2102: 2098: 2053: 2044: 2037: 2025:"Chapter 3.8". 2024: 2023: 2019: 1980: 1973: 1924: 1920: 1875: 1864: 1819: 1808: 1777:(4): CD007415. 1763: 1756: 1711: 1674: 1667: 1654: 1653: 1624: 1579: 1560: 1555: 1519:Medicine portal 1517: 1512: 1510: 1507: 1490: 1478: 1454: 1449: 1429:Percival Bailey 1421: 1402: 1303: 1260:A good initial 1243: 1231: 1223: 1193: 1147: 1118: 1085:corticosteroids 1081:anticonvulsants 1077: 1040: 1031: 1024: 1018:pseudopalisades 1014: 1005: 998: 941:MR spectroscopy 888: 879: 855: 847: 830: 814: 789: 701:neurofibromin 1 641: 558:Cell of origin 523: 511:corpus callosum 439: 419: 411:cytomegalovirus 380: 372:Turcot syndrome 364: 356: 332: 271:, and previous 254:unconsciousness 205:Life expectancy 108:Usually unclear 22: 17: 12: 11: 5: 7722: 7712: 7711: 7706: 7701: 7696: 7679: 7678: 7668: 7665: 7664: 7662: 7661: 7655: 7653: 7649: 7648: 7646: 7645: 7640: 7639: 7638: 7624: 7623: 7622: 7617: 7609: 7604: 7603: 7602: 7597: 7586: 7584: 7577: 7576: 7573: 7572: 7570: 7569: 7563: 7561: 7555: 7554: 7552: 7551: 7546: 7540: 7538: 7532: 7531: 7528: 7527: 7525: 7524: 7519: 7514: 7508: 7506: 7502: 7501: 7499: 7498: 7493: 7488: 7483: 7481:Retinoblastoma 7478: 7472:Ganglioneuroma 7468: 7466: 7458: 7457: 7454: 7453: 7451: 7450: 7445: 7440: 7434: 7432: 7428: 7427: 7425: 7424: 7423: 7422: 7417: 7406: 7404: 7402:Choroid plexus 7398: 7397: 7395: 7394: 7389: 7383: 7381: 7375: 7374: 7372: 7371: 7366: 7360: 7358: 7352: 7351: 7349: 7348: 7347: 7346: 7341: 7336: 7331: 7326: 7321: 7310: 7308: 7299: 7290: 7270: 7264: 7263: 7260: 7259: 7257: 7256: 7250: 7248: 7240: 7239: 7237: 7236: 7231: 7225: 7223: 7209: 7203: 7202: 7195: 7194: 7187: 7180: 7172: 7163: 7162: 7159: 7158: 7143: 7142: 7140: 7136: 7135: 7132: 7131: 7120: 7109: 7098: 7087: 7072: 7056: 7051: 7050: 7048: 7047:Classification 7041: 7040: 7022: 7021:External links 7019: 7016: 7015: 6997: 6956: 6929:(3): 437–446. 6913: 6886:(7): 957–972. 6870: 6816: 6765: 6736:(1): vdaa013. 6716: 6681: 6630: 6601:(2): 197–208. 6581: 6552:(2): 213–222. 6532: 6503:(5): 591–613. 6483: 6470: 6421: 6370: 6319: 6306:(2): S135–36. 6286: 6267: 6224: 6178: 6134: 6085: 6058:(5): 670–675. 6042: 6013:(1): 207–212. 5993: 5942: 5913:(4): 697–709. 5893: 5864:(3): 303–305. 5858:Neuro-Oncology 5844: 5806: 5765: 5729: 5697: 5668:(6): 976–987. 5648: 5599: 5546: 5519:(3): 315–319. 5503: 5460: 5434: 5407: 5357: 5338: 5303: 5259: 5240:(3): 820–824. 5224: 5205:(3): 333–343. 5188: 5153: 5132:(1–2): 36–44. 5112: 5060: 5031:(1): 102–113. 5011: 4990:(1–2): 36–44. 4967: 4938:(2): 131–142. 4918: 4869: 4834:Neuro-Oncology 4820: 4801:(5): 392–401. 4784: 4765:(2): 190–198. 4748: 4699: 4672:(4): 311–318. 4656: 4607: 4571: 4542:(9): 707–716. 4522: 4473: 4454:(2): 525–551. 4438: 4409:(3): 170–186. 4380: 4331: 4286: 4229: 4200:(5): 620–632. 4194:Molecular Cell 4180: 4151:(1): 131–144. 4131: 4094:ISRN Neurology 4080: 4029: 4006: 3980: 3937: 3896: 3889: 3863: 3828: 3787: 3768:(2): 326–341. 3746: 3711:Neuro-Oncology 3694: 3643: 3608: 3556: 3515: 3474: 3422: 3387:Neuro-Oncology 3373: 3338:Neuro-Oncology 3324: 3303:(6): 803–820. 3283: 3234: 3227: 3201: 3170:(4): 321–332. 3150: 3099: 3070:(5): a020610. 3050: 3021:(4): 383–394. 3001: 2966: 2923: 2904:(2): 129–137. 2888: 2837: 2788: 2745: 2704: 2655: 2636:(8): 675–684. 2620: 2599:(6): 479–489. 2579: 2536: 2501:Neuro-Oncology 2487: 2466:(4): 386–393. 2446: 2402: 2367: 2332:Neuro-Oncology 2318: 2299:(4): 981–998. 2280: 2269: 2246: 2219:(5): 459–466. 2202: 2145: 2116:(3): 166–193. 2096: 2042: 2035: 2017: 1990:(4): 417–421. 1971: 1918: 1862: 1827:Neuro-Oncology 1806: 1754: 1672: 1665: 1622: 1557: 1556: 1554: 1551: 1550: 1549: 1544: 1539: 1534: 1529: 1523: 1522: 1506: 1503: 1489: 1486: 1477: 1474: 1453: 1450: 1448: 1445: 1433:Harvey Cushing 1420: 1417: 1401: 1398: 1395: 1394: 1390: 1389: 1386: 1383: 1380: 1377: 1374: 1370: 1369: 1365: 1364: 1361: 1358: 1355: 1352: 1349: 1345: 1344: 1341: 1338: 1335: 1332: 1325: 1321: 1320: 1317: 1314: 1311: 1308: 1305: 1253:and increased 1251:cerebral edema 1242: 1239: 1230: 1227: 1222: 1219: 1198:clinical trial 1192: 1189: 1146: 1143: 1117: 1114: 1113: 1112: 1105: 1076: 1073: 1069: 1068: 1061: 1058: 1055: 1039: 1036: 1030: 1027: 1026: 1025: 1015: 1008: 1006: 1001:Histopathology 999: 992: 887: 884: 878: 875: 854: 851: 845: 829: 826: 813: 810: 788: 785: 784: 783: 780: 765: 713: 712: 693: 682:(p53), and in 674: 640: 637: 634: 633: 630: 626: 625: 622: 618: 617: 614: 610: 609: 606: 602: 601: 598: 594: 593: 589: 588: 585: 581: 580: 577: 573: 572: 569: 565: 564: 559: 555: 554: 551: 541:glioblastoma. 532:sections. The 522: 519: 443:immunostaining 438: 435: 418: 415: 379: 376: 363: 360: 355: 352: 331: 328: 302:, after which 217: 216: 213: 209: 208: 202: 196: 195: 186: 180: 179: 166: 162: 161: 158: 154: 153: 140: 134: 133: 116: 110: 109: 106: 102: 101: 98: 94: 93: 79: 73: 72: 66:Neuro-oncology 63: 57: 56: 46: 45: 37: 36: 33: 29: 28: 20: 15: 9: 6: 4: 3: 2: 7721: 7710: 7707: 7705: 7702: 7700: 7697: 7695: 7692: 7691: 7689: 7675: 7673: 7666: 7660: 7657: 7656: 7654: 7650: 7644: 7641: 7637: 7634: 7633: 7632: 7628: 7625: 7621: 7618: 7616: 7613: 7612: 7610: 7608: 7605: 7601: 7598: 7596: 7593: 7592: 7591: 7590:Neuroblastoma 7588: 7587: 7585: 7582: 7578: 7568: 7565: 7564: 7562: 7560: 7559:Hematopoietic 7556: 7550: 7547: 7545: 7542: 7541: 7539: 7537: 7533: 7523: 7520: 7518: 7515: 7513: 7510: 7509: 7507: 7503: 7497: 7494: 7492: 7489: 7487: 7484: 7482: 7479: 7477: 7476:Ganglioglioma 7473: 7470: 7469: 7467: 7465: 7459: 7449: 7446: 7444: 7441: 7439: 7436: 7435: 7433: 7429: 7421: 7418: 7416: 7413: 7412: 7411: 7408: 7407: 7405: 7403: 7399: 7393: 7392:Subependymoma 7390: 7388: 7385: 7384: 7382: 7380: 7376: 7370: 7367: 7365: 7362: 7361: 7359: 7357: 7353: 7345: 7342: 7340: 7337: 7335: 7332: 7330: 7327: 7325: 7322: 7320: 7317: 7316: 7315: 7312: 7311: 7309: 7307: 7303: 7300: 7298: 7294: 7291: 7288: 7287:spinal tumors 7283: 7278: 7274: 7271: 7269: 7265: 7255: 7252: 7251: 7249: 7246: 7241: 7235: 7232: 7230: 7227: 7226: 7224: 7221: 7219: 7213: 7210: 7208: 7204: 7200: 7193: 7188: 7186: 7181: 7179: 7174: 7173: 7170: 7157: 7154: 7150: 7149: 7145: 7144: 7141: 7137: 7130: 7126: 7125: 7121: 7119: 7115: 7114: 7110: 7108: 7104: 7103: 7099: 7097: 7093: 7092: 7088: 7086: 7082: 7081: 7077: 7073: 7071: 7067: 7066: 7062: 7058: 7057: 7054: 7049: 7045: 7039: 7035: 7031: 7028: 7025: 7024: 7013: 7009: 7008: 7001: 6993: 6989: 6984: 6979: 6975: 6971: 6967: 6960: 6952: 6948: 6944: 6940: 6936: 6932: 6928: 6924: 6917: 6909: 6905: 6901: 6897: 6893: 6889: 6885: 6881: 6874: 6866: 6862: 6857: 6852: 6847: 6842: 6838: 6834: 6830: 6823: 6821: 6812: 6808: 6803: 6798: 6793: 6788: 6784: 6780: 6776: 6769: 6761: 6757: 6752: 6747: 6743: 6739: 6735: 6731: 6727: 6720: 6712: 6708: 6704: 6700: 6696: 6692: 6685: 6677: 6673: 6668: 6663: 6658: 6653: 6649: 6645: 6641: 6634: 6626: 6622: 6617: 6612: 6608: 6604: 6600: 6596: 6592: 6585: 6577: 6573: 6568: 6563: 6559: 6555: 6551: 6547: 6543: 6536: 6528: 6524: 6519: 6514: 6510: 6506: 6502: 6498: 6494: 6487: 6480: 6474: 6466: 6462: 6457: 6452: 6448: 6444: 6440: 6436: 6432: 6425: 6417: 6413: 6408: 6403: 6398: 6393: 6389: 6385: 6381: 6374: 6366: 6362: 6357: 6352: 6347: 6342: 6338: 6334: 6330: 6323: 6314: 6309: 6305: 6301: 6297: 6290: 6281: 6277: 6271: 6263: 6259: 6255: 6251: 6247: 6243: 6239: 6235: 6228: 6220: 6216: 6211: 6206: 6202: 6198: 6194: 6187: 6185: 6183: 6174: 6170: 6165: 6160: 6156: 6152: 6148: 6141: 6139: 6130: 6126: 6121: 6116: 6112: 6108: 6104: 6100: 6096: 6089: 6081: 6077: 6073: 6069: 6065: 6061: 6057: 6053: 6046: 6038: 6034: 6029: 6024: 6020: 6016: 6012: 6008: 6004: 5997: 5989: 5985: 5980: 5975: 5970: 5965: 5961: 5957: 5953: 5946: 5938: 5934: 5929: 5924: 5920: 5916: 5912: 5908: 5904: 5897: 5889: 5885: 5880: 5875: 5871: 5867: 5863: 5859: 5855: 5848: 5840: 5836: 5832: 5828: 5824: 5820: 5813: 5811: 5802: 5798: 5793: 5788: 5784: 5780: 5776: 5769: 5750: 5746: 5739: 5733: 5717: 5713: 5712: 5707: 5701: 5693: 5689: 5684: 5679: 5675: 5671: 5667: 5663: 5659: 5652: 5644: 5640: 5635: 5630: 5626: 5622: 5618: 5614: 5610: 5603: 5596: 5591: 5587: 5582: 5577: 5573: 5569: 5565: 5561: 5557: 5550: 5542: 5538: 5534: 5530: 5526: 5522: 5518: 5514: 5507: 5499: 5495: 5491: 5487: 5483: 5479: 5475: 5471: 5464: 5448: 5444: 5438: 5430: 5426: 5422: 5418: 5411: 5403: 5399: 5395: 5391: 5386: 5381: 5377: 5373: 5369: 5361: 5354: 5350: 5349: 5342: 5334: 5330: 5326: 5322: 5318: 5314: 5307: 5299: 5295: 5291: 5287: 5283: 5279: 5275: 5271: 5263: 5255: 5251: 5247: 5243: 5239: 5235: 5228: 5220: 5216: 5212: 5208: 5204: 5200: 5192: 5184: 5180: 5176: 5172: 5168: 5164: 5157: 5149: 5145: 5140: 5135: 5131: 5127: 5123: 5116: 5108: 5104: 5099: 5094: 5090: 5086: 5082: 5078: 5074: 5067: 5065: 5056: 5052: 5047: 5042: 5038: 5034: 5030: 5026: 5022: 5015: 5007: 5003: 4998: 4993: 4989: 4985: 4981: 4974: 4972: 4963: 4959: 4954: 4949: 4945: 4941: 4937: 4933: 4929: 4922: 4914: 4910: 4905: 4900: 4896: 4892: 4888: 4884: 4880: 4873: 4865: 4861: 4856: 4851: 4847: 4843: 4839: 4835: 4831: 4824: 4816: 4812: 4808: 4804: 4800: 4796: 4788: 4780: 4776: 4772: 4768: 4764: 4760: 4752: 4744: 4740: 4735: 4730: 4726: 4722: 4718: 4714: 4710: 4703: 4695: 4691: 4687: 4683: 4679: 4675: 4671: 4667: 4660: 4652: 4648: 4643: 4638: 4634: 4630: 4626: 4622: 4618: 4611: 4595: 4591: 4587: 4586: 4581: 4575: 4567: 4563: 4558: 4553: 4549: 4545: 4541: 4537: 4533: 4526: 4518: 4514: 4509: 4504: 4500: 4496: 4492: 4488: 4484: 4477: 4469: 4465: 4461: 4457: 4453: 4449: 4448:Radiographics 4442: 4434: 4430: 4425: 4420: 4416: 4412: 4408: 4404: 4400: 4393: 4391: 4389: 4387: 4385: 4376: 4372: 4367: 4362: 4358: 4354: 4350: 4346: 4342: 4335: 4327: 4323: 4319: 4315: 4311: 4307: 4300: 4293: 4291: 4282: 4278: 4273: 4268: 4264: 4260: 4256: 4252: 4248: 4244: 4240: 4233: 4225: 4221: 4216: 4211: 4207: 4203: 4199: 4195: 4191: 4184: 4176: 4172: 4167: 4162: 4158: 4154: 4150: 4146: 4142: 4135: 4127: 4123: 4118: 4113: 4108: 4103: 4099: 4095: 4091: 4084: 4076: 4072: 4067: 4062: 4057: 4052: 4048: 4044: 4040: 4033: 4025: 4021: 4017: 4013: 4009: 4003: 3999: 3995: 3991: 3984: 3976: 3972: 3968: 3964: 3960: 3956: 3952: 3948: 3941: 3933: 3929: 3924: 3919: 3915: 3911: 3907: 3900: 3892: 3886: 3882: 3878: 3874: 3867: 3859: 3855: 3851: 3847: 3843: 3839: 3832: 3824: 3820: 3815: 3810: 3806: 3802: 3798: 3791: 3783: 3779: 3775: 3771: 3767: 3763: 3755: 3753: 3751: 3742: 3738: 3733: 3728: 3724: 3720: 3716: 3712: 3708: 3701: 3699: 3690: 3686: 3681: 3676: 3671: 3666: 3662: 3658: 3654: 3647: 3639: 3635: 3631: 3627: 3623: 3619: 3612: 3604: 3600: 3595: 3590: 3586: 3582: 3579:(1): 98–110. 3578: 3574: 3570: 3563: 3561: 3552: 3548: 3543: 3538: 3534: 3530: 3526: 3519: 3511: 3507: 3502: 3497: 3494:(7279): 278. 3493: 3489: 3485: 3478: 3470: 3466: 3461: 3456: 3452: 3448: 3444: 3440: 3436: 3429: 3427: 3418: 3414: 3409: 3404: 3400: 3396: 3392: 3388: 3384: 3377: 3369: 3365: 3360: 3355: 3351: 3347: 3343: 3339: 3335: 3328: 3320: 3316: 3311: 3306: 3302: 3298: 3294: 3287: 3279: 3275: 3270: 3265: 3261: 3257: 3254:(2): 97–109. 3253: 3249: 3245: 3238: 3230: 3224: 3220: 3216: 3212: 3205: 3197: 3193: 3188: 3183: 3178: 3173: 3169: 3165: 3161: 3154: 3146: 3142: 3137: 3132: 3127: 3122: 3118: 3114: 3110: 3103: 3095: 3091: 3086: 3081: 3077: 3073: 3069: 3065: 3061: 3054: 3046: 3042: 3037: 3032: 3028: 3024: 3020: 3016: 3012: 3005: 2997: 2993: 2989: 2985: 2981: 2977: 2970: 2962: 2958: 2954: 2950: 2946: 2942: 2938: 2934: 2927: 2919: 2915: 2911: 2907: 2903: 2899: 2892: 2884: 2880: 2875: 2870: 2865: 2860: 2856: 2852: 2848: 2841: 2833: 2829: 2824: 2819: 2815: 2811: 2807: 2803: 2799: 2792: 2784: 2780: 2776: 2772: 2768: 2764: 2760: 2756: 2749: 2741: 2737: 2732: 2727: 2723: 2719: 2715: 2708: 2700: 2696: 2691: 2686: 2682: 2678: 2674: 2670: 2666: 2659: 2651: 2647: 2643: 2639: 2635: 2631: 2624: 2616: 2612: 2607: 2602: 2598: 2594: 2590: 2583: 2575: 2571: 2567: 2563: 2559: 2555: 2551: 2547: 2540: 2532: 2528: 2523: 2518: 2514: 2510: 2506: 2502: 2498: 2491: 2483: 2479: 2474: 2469: 2465: 2461: 2457: 2450: 2442: 2438: 2434: 2430: 2426: 2422: 2415: 2413: 2411: 2409: 2407: 2398: 2394: 2390: 2386: 2382: 2378: 2371: 2363: 2359: 2354: 2349: 2345: 2341: 2337: 2333: 2329: 2322: 2314: 2310: 2306: 2302: 2298: 2294: 2287: 2285: 2276: 2272: 2266: 2262: 2261: 2253: 2251: 2242: 2238: 2234: 2230: 2226: 2222: 2218: 2214: 2206: 2198: 2194: 2190: 2186: 2181: 2176: 2172: 2168: 2165:(1): 100916. 2164: 2160: 2156: 2149: 2141: 2137: 2132: 2127: 2123: 2119: 2115: 2111: 2107: 2100: 2092: 2088: 2083: 2078: 2074: 2070: 2066: 2062: 2058: 2051: 2049: 2047: 2038: 2032: 2028: 2021: 2013: 2009: 2005: 2001: 1997: 1993: 1989: 1985: 1978: 1976: 1967: 1963: 1959: 1955: 1950: 1945: 1941: 1937: 1933: 1929: 1922: 1914: 1910: 1905: 1900: 1896: 1892: 1888: 1884: 1880: 1873: 1871: 1869: 1867: 1858: 1854: 1849: 1844: 1840: 1836: 1832: 1828: 1824: 1817: 1815: 1813: 1811: 1802: 1798: 1793: 1788: 1784: 1780: 1776: 1772: 1768: 1761: 1759: 1750: 1746: 1741: 1736: 1732: 1728: 1724: 1720: 1716: 1709: 1707: 1705: 1703: 1701: 1699: 1697: 1695: 1693: 1691: 1689: 1687: 1685: 1683: 1681: 1679: 1677: 1668: 1662: 1658: 1651: 1649: 1647: 1645: 1643: 1641: 1639: 1637: 1635: 1633: 1631: 1629: 1627: 1618: 1614: 1609: 1604: 1600: 1596: 1592: 1588: 1584: 1577: 1575: 1573: 1571: 1569: 1567: 1565: 1563: 1558: 1548: 1545: 1543: 1540: 1538: 1535: 1533: 1530: 1528: 1525: 1524: 1520: 1509: 1502: 1500: 1496: 1485: 1482: 1473: 1470: 1465: 1463: 1462:nanoparticles 1458: 1444: 1442: 1438: 1434: 1430: 1426: 1416: 1414: 1410: 1405: 1392: 1391: 1375: 1371: 1367: 1366: 1350: 1346: 1342: 1339: 1336: 1333: 1330: 1327:Age < 50, 1326: 1323: 1322: 1318: 1315: 1312: 1309: 1306: 1301: 1300: 1297: 1294: 1291: 1287: 1285: 1281: 1278: 1274: 1270: 1267: 1263: 1258: 1256: 1252: 1247: 1238: 1235: 1226: 1221:Immunotherapy 1218: 1215: 1211: 1207: 1203: 1199: 1188: 1186: 1182: 1178: 1174: 1170: 1165: 1163: 1155: 1151: 1142: 1138: 1136: 1130: 1122: 1110: 1109:dexamethasone 1106: 1103: 1099: 1095: 1090: 1089: 1088: 1086: 1082: 1072: 1066: 1062: 1059: 1056: 1053: 1052: 1051: 1044: 1035: 1023: 1019: 1012: 1007: 1002: 996: 991: 990: 989: 986: 982: 977: 976: 970: 966: 962: 961: 956: 955: 950: 945: 942: 937: 933: 929: 925: 921: 912: 905: 900: 892: 883: 874: 872: 868: 864: 860: 850: 843: 839: 835: 825: 823: 819: 809: 807: 802: 798: 794: 781: 778: 774: 770: 766: 763: 759: 755: 751: 747: 746: 745: 742: 739: 737: 733: 728: 726: 722: 717: 710: 706: 702: 698: 694: 691: 687: 686: 681: 680: 675: 672: 671:amplification 668: 664: 663: 658: 654: 650: 646: 645: 644: 631: 628: 627: 623: 620: 619: 615: 612: 611: 607: 604: 603: 599: 596: 595: 590: 586: 583: 582: 578: 575: 574: 570: 567: 566: 563: 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