Glioblastoma multiforme

Glioblastoma multiforme (GBM) is the most common adult primary brain tumor. Despite the standard of care of radiotherapy with concurrent and adjuvant temozolomide chemotherapy, prognosis is poor, with a median survival of approximately 16 months. Tumor recurrence within the high dose irradiation field occurs in up to 80% of patients, suggesting a role for further radiation dose intensification. One means to intensify dose is through radiotherapy hypofractionation with large doses per fraction or with radiosurgery. This chapter will review the past results of hypofractionated radiotherapy and stereotactic radiosurgery for patients with GBM, both at initial diagnosis and after recurrence. The CyberKnife is uniquely capable of delivering radiotherapy and radiosurgery at all phases of the treatment course of GBM.