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Advances in Brain Tumor Surgery for Glioblastoma in Adults

Glioblastoma (GBM) is the most common primary intracranial neoplasia, and is characterized by its extremely poor prognosis. Despite maximum surgery, chemotherapy, and radiation, the histological heterogeneity of GBM makes total eradication impossible, due to residual cancer cells invading the parenc...

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Autores principales: Lara-Velazquez, Montserrat, Al-Kharboosh, Rawan, Jeanneret, Stephanie, Vazquez-Ramos, Carla, Mahato, Deependra, Tavanaiepour, Daryoush, Rahmathulla, Gazanfar, Quinones-Hinojosa, Alfredo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5742769/
https://www.ncbi.nlm.nih.gov/pubmed/29261148
http://dx.doi.org/10.3390/brainsci7120166
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author Lara-Velazquez, Montserrat
Al-Kharboosh, Rawan
Jeanneret, Stephanie
Vazquez-Ramos, Carla
Mahato, Deependra
Tavanaiepour, Daryoush
Rahmathulla, Gazanfar
Quinones-Hinojosa, Alfredo
author_facet Lara-Velazquez, Montserrat
Al-Kharboosh, Rawan
Jeanneret, Stephanie
Vazquez-Ramos, Carla
Mahato, Deependra
Tavanaiepour, Daryoush
Rahmathulla, Gazanfar
Quinones-Hinojosa, Alfredo
author_sort Lara-Velazquez, Montserrat
collection PubMed
description Glioblastoma (GBM) is the most common primary intracranial neoplasia, and is characterized by its extremely poor prognosis. Despite maximum surgery, chemotherapy, and radiation, the histological heterogeneity of GBM makes total eradication impossible, due to residual cancer cells invading the parenchyma, which is not otherwise seen in radiographic images. Even with gross total resection, the heterogeneity and the dormant nature of brain tumor initiating cells allow for therapeutic evasion, contributing to its recurrence and malignant progression, and severely impacting survival. Visual delimitation of the tumor’s margins with common surgical techniques is a challenge faced by many surgeons. In an attempt to achieve optimal safe resection, advances in approaches allowing intraoperative analysis of cancer and non-cancer tissue have been developed and applied in humans resulting in improved outcomes. In addition, functional paradigms based on stimulation techniques to map the brain’s electrical activity have optimized glioma resection in eloquent areas such as the Broca’s, Wernike’s and perirolandic areas. In this review, we will elaborate on the current standard therapy for newly diagnosed and recurrent glioblastoma with a focus on surgical approaches. We will describe current technologies used for glioma resection, such as awake craniotomy, fluorescence guided surgery, laser interstitial thermal therapy and intraoperative mass spectrometry. Additionally, we will describe a newly developed tool that has shown promising results in preclinical experiments for brain cancer: optical coherence tomography.
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spelling pubmed-57427692017-12-29 Advances in Brain Tumor Surgery for Glioblastoma in Adults Lara-Velazquez, Montserrat Al-Kharboosh, Rawan Jeanneret, Stephanie Vazquez-Ramos, Carla Mahato, Deependra Tavanaiepour, Daryoush Rahmathulla, Gazanfar Quinones-Hinojosa, Alfredo Brain Sci Review Glioblastoma (GBM) is the most common primary intracranial neoplasia, and is characterized by its extremely poor prognosis. Despite maximum surgery, chemotherapy, and radiation, the histological heterogeneity of GBM makes total eradication impossible, due to residual cancer cells invading the parenchyma, which is not otherwise seen in radiographic images. Even with gross total resection, the heterogeneity and the dormant nature of brain tumor initiating cells allow for therapeutic evasion, contributing to its recurrence and malignant progression, and severely impacting survival. Visual delimitation of the tumor’s margins with common surgical techniques is a challenge faced by many surgeons. In an attempt to achieve optimal safe resection, advances in approaches allowing intraoperative analysis of cancer and non-cancer tissue have been developed and applied in humans resulting in improved outcomes. In addition, functional paradigms based on stimulation techniques to map the brain’s electrical activity have optimized glioma resection in eloquent areas such as the Broca’s, Wernike’s and perirolandic areas. In this review, we will elaborate on the current standard therapy for newly diagnosed and recurrent glioblastoma with a focus on surgical approaches. We will describe current technologies used for glioma resection, such as awake craniotomy, fluorescence guided surgery, laser interstitial thermal therapy and intraoperative mass spectrometry. Additionally, we will describe a newly developed tool that has shown promising results in preclinical experiments for brain cancer: optical coherence tomography. MDPI 2017-12-20 /pmc/articles/PMC5742769/ /pubmed/29261148 http://dx.doi.org/10.3390/brainsci7120166 Text en © 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Lara-Velazquez, Montserrat
Al-Kharboosh, Rawan
Jeanneret, Stephanie
Vazquez-Ramos, Carla
Mahato, Deependra
Tavanaiepour, Daryoush
Rahmathulla, Gazanfar
Quinones-Hinojosa, Alfredo
Advances in Brain Tumor Surgery for Glioblastoma in Adults
title Advances in Brain Tumor Surgery for Glioblastoma in Adults
title_full Advances in Brain Tumor Surgery for Glioblastoma in Adults
title_fullStr Advances in Brain Tumor Surgery for Glioblastoma in Adults
title_full_unstemmed Advances in Brain Tumor Surgery for Glioblastoma in Adults
title_short Advances in Brain Tumor Surgery for Glioblastoma in Adults
title_sort advances in brain tumor surgery for glioblastoma in adults
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5742769/
https://www.ncbi.nlm.nih.gov/pubmed/29261148
http://dx.doi.org/10.3390/brainsci7120166
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