Potential improvement of survival statistics for glioblastoma multiforme (WHO IV)

Abstract

The present-day treatment of a glioblastoma multiforme IV (glioblast) is by surgery, radiation, and chemotherapy. Unfortunately, the current treatment has not significantly improved the survival statistics of this tumor. There are now two relatively new surgical procedures that may improve the survival statistics of this malignancy. One of these procedures is the intraoperative use of the drug 5-aminovolumic acid (ALA), which fluoresces a red color in malignant brain tissue that is not observed in normal brain tissue. This allows a neurosurgeon to distinguish brain tissue infiltrated by malignant cells, thus allowing a more complete resection of the tumor. Another procedure that has the potential to improve the survival statistics of glioblasts is the use of the omentum. Direct placement of the omentum on a brain infiltrated by malignant cells would allow omental blood vessels, known to be completely clear of endothelial cells, to penetrate directly into the underlying brain. The blood flow through omental blood vessels could be expected to carry chemotherapeutic agents throughout the involved brain, thereby totally bypassing the blood–brain barrier. Combining a tumor resection using 5-ALA and placing the omentum on the brain may prove instrumental in improving the survival statistics of patients suffering from a glioblast.