, Volume 89, Issue 3, pp 339-357
Date: 20 Aug 2008

Cytotoxic chemotherapeutic management of newly diagnosed glioblastoma multiforme

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Recommendations

Level I:

Concurrent and post-irradiation temozolomide is recommended in patients 18–70 years of age with adequate systemic health. This recommendation is supported on evidence from a single class I study.

Level II:

BCNU-impregnated biodegradable polymers are recommended in patients for whom craniotomy is indicated. This recommendation based on the evidence from two class II studies.

Level III:

The addition of temozolomide to radiation therapy is an option for patients with newly diagnosed glioblastoma (GBM) who are older than 70 years with a Karnofsky performance status (KPS) above 50. For patients 70 years or older with newly diagnosed GBM, temozolomide alone is a well tolerated alternative to radiation therapy and its benefit might be comparable to that obtained with radiation therapy alone. Radiation therapy followed by one of the nitrosoureas is recommended for those patients who cannot receive temozolomide.

Rationale

Although chemotherapy is frequently used to treat newly