Treatment of Recurrent High-Grade Glioma including GBM

High-grade gliomas regrow in most patients.

Retreatment may help overall health is good, only a small amount of tumor has regrown and the time to tumor regrowth is long.

Options available for retreatment include surgery, various forms of radiation, chemotherapy, and electric fields.

Surgery

Good overall health, long time to regrowth and ability to remove most of the tumor improve chances of long survival after surgery.

Radiation

Usually, additional radiation is not possible because of the high risk of damage to normal brain tissue. Sometimes, special techniques like focused radiation (stereotactic radiosurgery) may allow re-treatment with radiation.

Chemotherapy

Chemotherapy is not as effective for recurrent high-grade gliomas. A medication called lomustine or another course of temozolomide can be used.

Bevacizumab

Bevacizumab (Brand name: Avastin) is an antibody (a type of protein) that interferes with growth of blood vessels and reduces brain swelling.

Electric fields

A battery-powered device that provides low-strength electric fields around the tumor (Optune-https://www.optune.com) is another treatment option. The device is applied directly to the scalp after the head is shaved and should to be worn for at least 18 hours per day.