علاج الورم الأرومي الدبقي المشخص حديثًا في المرضى الأكبر من 70 عامًا مع ضعف الحالة الوظيفية ومحفز MGMT غير المتحول

References

DOI: 10.1093/neuonc/noaf177

• Treatment decisions for glioblastoma after maximal safe resection depend on age, functional status, MGMT status, and patient care goals (Figure 8).
• Treatment regimens for newly diagnosed glioblastoma patients older than 65–70 years involve standard radiochemotherapy but shortened regimens for frailer patients may include hypofractionated radiation (eg, 40 Gy in 15 fractions) with temozolomide, hypofractionated radiation alone for patients with MGMT unmethylated glioblastoma, or temozolomide alone for patients with MGMT methylated glioblastoma.
• Nevertheless, the goal for glioblastoma surgery should be maximal safe resection of the enhancing and non-enhancing solid tumor whenever feasible.
• Whenever microsurgical resection is deemed to be too risky based on the patient's medical condition and/or the functional topography of the affected brain region, a stereotactic or open biopsy should be performed to obtain a histological and molecular diagnosis.
• For patients in whom conventional, open surgical approaches are not deemed optimal because of surgical risk, MRI-guided laser interstitial thermal therapy, a minimally invasive technique designed to ablate tumors, is sometimes an option.