This trial is evaluating whether Procedure: LITT will improve 1 primary outcome and 6 secondary outcomes in patients with Glioblastoma. Measurement will happen over the course of 2 Years.
This trial requires 32 total participants across 2 different treatment groups
This trial involves 2 different treatments. Procedure: LITT is the primary treatment being studied. Participants will all receive the same treatment. There is no placebo group. The treatments being tested are not being studied for commercial purposes.
Treatments for glioblastoma are multifactorial and do not use the same principles all the time. Treatments are used on the basis of the type or location of the tumor, the age and health of the patient (the “risk-benefit ratio”), the treatment's side effects, the person's desires and fears about treatment choices, and other factors. The treatments vary by the type, location, and stage of this tumor. Many of the treatment options have been developed since 1950, when the first chemotherapy drugs were formulated. The newer therapy options include targeted therapies and other innovative approaches.
The signs of glioblastoma begin before a person is affected with symptoms of the disease. The following symptoms are common.\n- Loss of coordination with walking.\n- Visual disturbances.\n- Visual complaints about ringing in the ears.\n- Headache.\n- Seizures.\n- Weakness.\n- Dizziness.\n- Confusion.\n- Memory loss.\n- A persistent, dull pain in the limbs.
The cause of glioblastoma is not clear and is likely related to a combination of factors such as the environmental exposures which have a significant effect on tumour susceptibility in genetically susceptible individuals, and on tumour development and progression following exposure to these environmental exposures; genetics, epigenetics - DNA alterations which occur in glioblastoma during tumorigenesis; and brain injury, especially in the periventricular nodule of the primitive telencephalon.
The majority of the glioblastoma tumor is glial in nature and is an invasive tumor with fast growth rates. Survival after glioblastoma surgery has improved over the last few decades. The current study is intended to provide an updated review of the use of bevacizumab as a second-line agent in glioblastoma. For glioblastoma patients who receive bevacizumab, a trend for improved overall survival was observed. However, an increased risk of serious adverse events was observed. If confirmed in future studies, these findings may limit the use of bevacizumab in the glioblastoma patient population.
Fewer than 10,000 cases are diagnosed each year with glioblastoma in the United States. More research is needed to identify risk factors for the disease, to improve the diagnosis and management of patients with the condition, and to identify ways of improving the long-term survival of patients with glioblastoma.
Results from a recent clinical trial suggests an increase in the rate of metastases to distant sites during times of greater tumour diameter growth, a trend found previously with tumours in other sites such as prostate and breast. Furthermore, more rapid rates of growth and metastatic spread were found to be associated with longer duration of clinical control before diagnosis and with progression-free survival in overall and OSA/PDS, but not in OS.
In conclusion, according to surgeon and in our personal experience, we believe that litt surgery should be performed only in selected patients with a good-quality life expectancy. If surgery is indicated it will allow the patients to have a longer life with fewer symptoms - even in the case in which the tumor is located in an eloquent brain area.
Recent studies, in which the authors have participated, have mostly evaluated adjuvant therapy using temozolomide alone, which may be a viable option. In a recent article, a study done as a randomized design was mentioned. There's a phase II study using the same regimen as the phase I study\n
The median survival time from diagnosis of glioblastoma is approximately 12 months and survival remains dismal. This may be due to the extent of maximal surgical removal and/or the presence of diffuse disease. We would recommend that most patients with glioblastomas should have a total surgical excision with maximal surgical removal and adjuvant chemotherapy. There are many factors related to the survival outcome including age, gender, extent of resection, tumor burden, degree of neuropathic component, grade, and resected hemisphere and hemisphere involvement. Survival for glioblastoma is worse than that for the malignant glioma of other types.
Our studies show no significant difference in the QoL for the 2 surgical procedures performed, though there is a trend for patients undergoing craniotomy to have better overall QoL. Patients who undergo craniotomy reported a higher frequency of vomiting and nausea, regardless of the surgery procedure performed and type of adjuvant therapy (conventional chemotherapy or multimodality therapy of radiation therapy and chemotherapy) received.
The majority of patients prefer this operation than a traditional craniotomy. Even though this operation requires a longer time until the mobilization of the patient and of the cranial vault, then there is no significant difference in the quality of the neurological outcome.