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...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2017-12-01
|
| Series: | Brain Sciences |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2076-3425/7/12/166 |
| _version_ | 1818696309431861248 |
|---|---|
| author | Montserrat Lara-Velazquez Rawan Al-Kharboosh Stephanie Jeanneret Carla Vazquez-Ramos Deependra Mahato Daryoush Tavanaiepour Gazanfar Rahmathulla Alfredo Quinones-Hinojosa |
| author_facet | Montserrat Lara-Velazquez Rawan Al-Kharboosh Stephanie Jeanneret Carla Vazquez-Ramos Deependra Mahato Daryoush Tavanaiepour Gazanfar Rahmathulla Alfredo Quinones-Hinojosa |
| author_sort | Montserrat Lara-Velazquez |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-12-17T13:59:19Z |
| format | Article |
| id | doaj.art-cbf49aa5379645d7bab14a5829db89f1 |
| institution | Directory Open Access Journal |
| issn | 2076-3425 |
| language | English |
| last_indexed | 2024-12-17T13:59:19Z |
| publishDate | 2017-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Brain Sciences |
| spelling | doaj.art-cbf49aa5379645d7bab14a5829db89f12022-12-21T21:45:50ZengMDPI AGBrain Sciences2076-34252017-12-0171216610.3390/brainsci7120166brainsci7120166Advances in Brain Tumor Surgery for Glioblastoma in AdultsMontserrat Lara-Velazquez0Rawan Al-Kharboosh1Stephanie Jeanneret2Carla Vazquez-Ramos3Deependra Mahato4Daryoush Tavanaiepour5Gazanfar Rahmathulla6Alfredo Quinones-Hinojosa7Department of Neurosurgery, Mayo Clinic Florida, 4500 San Pablo Road, Jacksonville, FL 32224, USADepartment of Neurosurgery, Mayo Clinic Florida, 4500 San Pablo Road, Jacksonville, FL 32224, USADepartment of Neurosurgery, Mayo Clinic Florida, 4500 San Pablo Road, Jacksonville, FL 32224, USADepartment of Neurosurgery, Mayo Clinic Florida, 4500 San Pablo Road, Jacksonville, FL 32224, USADepartment of Neurosurgery, Mayo Clinic Florida, 4500 San Pablo Road, Jacksonville, FL 32224, USADepartment of Neurosurgery, University of Florida College of Medicine, 653 8th St W., Jacksonville, FL 32209, USADepartment of Neurosurgery, University of Florida College of Medicine, 653 8th St W., Jacksonville, FL 32209, USADepartment of Neurosurgery, Mayo Clinic Florida, 4500 San Pablo Road, Jacksonville, FL 32224, USAGlioblastoma (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.https://www.mdpi.com/2076-3425/7/12/166brain tumor surgerylaser therapyawake craniotomynovel treatments for gliomaoptical coherence tomography |
| spellingShingle | Montserrat Lara-Velazquez Rawan Al-Kharboosh Stephanie Jeanneret Carla Vazquez-Ramos Deependra Mahato Daryoush Tavanaiepour Gazanfar Rahmathulla Alfredo Quinones-Hinojosa Advances in Brain Tumor Surgery for Glioblastoma in Adults Brain Sciences brain tumor surgery laser therapy awake craniotomy novel treatments for glioma optical coherence tomography |
| 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 | brain tumor surgery laser therapy awake craniotomy novel treatments for glioma optical coherence tomography |
| url | https://www.mdpi.com/2076-3425/7/12/166 |
| work_keys_str_mv | AT montserratlaravelazquez advancesinbraintumorsurgeryforglioblastomainadults AT rawanalkharboosh advancesinbraintumorsurgeryforglioblastomainadults AT stephaniejeanneret advancesinbraintumorsurgeryforglioblastomainadults AT carlavazquezramos advancesinbraintumorsurgeryforglioblastomainadults AT deependramahato advancesinbraintumorsurgeryforglioblastomainadults AT daryoushtavanaiepour advancesinbraintumorsurgeryforglioblastomainadults AT gazanfarrahmathulla advancesinbraintumorsurgeryforglioblastomainadults AT alfredoquinoneshinojosa advancesinbraintumorsurgeryforglioblastomainadults |