Radiation Oncology in Glioblastoma (GBM)

This chapter provides a comprehensive overview of the management of glioblastoma (GBM), a highly aggressive primary brain tumor, with a specific focus on radiotherapy. GBM presents significant clinical challenges due to its low survival rates, complex molecular markers, and factors influencing prognosis, including extent of tumor resection, patient age, and Karnofsky performance status. The standard of care for GBM predominantly involves radiotherapy with concurrent temozolomide (TMZ) and maintenance TMZ, with TMZ efficacy closely linked to MGMT promoter methylation status. The chapter explores emerging immunotherapy strategies, particularly immune-checkpoint inhibitors (ICIs), to enhance GBM treatment and delves into radiosensitization techniques aimed at making cancer cells more susceptible to radiation therapy. Advanced imaging techniques in radiation therapy planning are discussed, emphasizing the role of MRI, PET scans, and functional imaging. The chapter underscores the need for ongoing research, especially concerning elderly patients, to improve radiotherapy-based strategies for this aggressive brain cancer.