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Essential Evidence for Glioblastoma: A Must-Know for Neurosurgery Exams
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Topic Overview
This exam-focused review covers seven evidence-based treatments for glioblastoma that neurosurgery trainees must master: Stupp protocol, extent of resection with RANO criteria, 5-ALA fluorescence guidance, awake craniotomy, tumor treating fields, bevacizumab, and intraoperative MRI. Designed to help candidates understand both the clinical rationale and exam-relevant details of current GBM management.
Key Takeaways
- Stupp protocol (surgery + radiotherapy + temozolomide) remains the standard-of-care foundation for glioblastoma treatment
- Maximal safe resection improves outcomes; RANO criteria provide standardized assessment of extent of resection
- 5-ALA fluorescence-guided surgery enhances tumor visualization and resection precision while preserving eloquent cortex
- Tumor treating fields (TTFields) offer a novel non-invasive adjuvant therapy option extending progression-free survival
- Intraoperative MRI enables real-time assessment to maximize resection while awake craniotomy preserves functional areas
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