56-year-old with speech difficulty
A 56-year-old female presents with one week of worsening memory, trouble finding words and using the wrong words intermittently. Her family also feels she is withdrawn. She is a non smoker and has no history of cancer. No serious medical problems.
Cranial nerves II-XII are intact
Strength- 5/5 upper extremities
No sensory loss
DTR wnl Cerebellar function and gait are normal
I would like to continue chemotherapeutic agents such as temodale, PCV, or CCNU rather than Tumor treating fields or Bevacizumab. Also I treat dendrite cell therapy in some cases.
Gliadel wafer still has a role for the treatment of GBM.
Very good case
Radical removal with navigation and possibly use of wafers.
Please subit your answers to see the case explanation.
- Stupp et al. Maintenance Therapy With Tumor-Treating Fields Plus Temozolomide vs Temozolomide Alone for Glioblastoma: A Randomized Clinical Trial. JAMA 2015.
- Chinot et al. Bevacizumab plus radiotherapy-temozolomide for newly diagnosed glioblastoma. NEJM, 2014.
- Gilbert et al. A randomized trial of bevacizumab for newly diagnosed glioblastoma. NEJM, 2014.
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