Glioblastoma
ICD-10 C71.9 · ICD-11 2A00.00

Treatment of Newly Diagnosed Glioblastoma in Patients Under 65–70 Years with Good Functional Status and MGMT-Unmethylated Tumours

This protocol addresses the initial management of newly diagnosed glioblastoma in a well-defined patient group: those younger than 65–70 years, presenting with good functional status, and whose tumours carry an unmethylated MGMT promoter.

Treatment decisions in this setting are guided by age, functional status, and MGMT methylation status. In patients under 65–70 years with good performance status, the modest benefits of standard treatments make participation in clinical trials highly recommended where available.

Surgical Approach — Overview

Management begins with surgical intervention, with the specific approach determined by tumour location, extent of involvement, and individual patient risk. The full algorithm — including the sequence of interventions and criteria for selecting among available surgical strategies — is detailed in the complete protocol.

Instant Access to Structured Evidence-Based Regimens

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).

Given the modest benefits of standard treatments, participation in clinical trials is highly recommended for patients with good performance status of any age.

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.

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