Glioblastoma

diagnosis and treatment of glioblastoma

The Clinica Universidad de Navarra has a Brain Tumours Area with a highly specialised team of experts and the most advanced technology for the diagnosis and treatment of this disease.

The Clínica has the series of patients with the largest average volume of glioblastoma extirpation. With fluorescence microscopy, complete extirpation is achieved in 83% of cases.

We are also at the cutting edge in treatments and research. We are the only centre in Spain that is conducting a study on the treatment of glioblastomas with immunotherapy using tailored vaccines combined with standard first-line treatment.

Moreover, the incorporation of magnetic resonance imaging [SP] and PET as diagnostic techniques represents a significant advance in the diagnosis of the disease and the application of treatment.

Imaging tests

The Clínica has the most advanced imaging tests.

  • Magnetic resonance imaging [SP] helps us see brain tissue lesions, their location and their size.
  • By adding the most sophisticated resonance and PET sequencing with methionine, the type of tumour can be determined.
  • This information can be transferred to navigation devices in the operating room that correlate these images with the actual space in which the surgeons work.

Biopsy

  • In order to establish an accurate diagnosis of the tumour type and grade, tissue needs to be taken and analysed by a neuropathologist.
  • The biopsy can be performed through open surgery or by image-guided puncture (stereotactic technique).
  • The stereotactic technique results in less discomfort for the patient. With a meticulous technique in the operating room and laboratory, it is possible to obtain a sample of sufficient quality and quantity for diagnosis and perform the necessary molecular marker tests.

Plasma analysis

  • This test detects the presence of the glioma and its grade of malignancy in cases in which, due to its location, it is impossible to perform a biopsy.

The use of fluorescent microscope gets double complete excisions of malignant brain tumors. [Video only available in Spanish]

The Clínica has the series of patients with the largest average volume of glioblastoma extirpation. Using a new technique, fluorescence microscopy, complete extirpation of the glioblastoma is achieved in 83% of cases. Our results have been published in international scientific journals.

In general, if the entire tumour is removed, grade 1 and some grade 2 tumours can be cured with surgery alone. For low-grade tumours that cannot be completely operated on and for grade 3 and 4 tumours, surgery should be followed by radiation therapy and chemotherapy.

Chemotherapy has been shown to be effective in extending survival for patients with high-grade gliomas.

The current standard is the use of temozolomide in combination with radiation therapy and for at least 6 cycles after the therapy.

In addition to this standard treatment, there are other options for which new data appear each year. The use of these second lines of treatment, whose use is more complex, depends on each case and on the oncologist’s experience.

Despite all the treatments, the progression of high-grade gliomas or glioblastomas cannot be halted in many cases. It is therefore important to continue studying them through basic research and clinical trials.

Radiation therapy can heal some benign tumours.

The correct planning and execution of radiation therapy is essential for ensuring that the tumour is applied the maximum possible dose while at same time preserving normal tissue. This precision depends on the specialist’s experience and care in the planning, on the available imaging tests for planning and on the available equipment.

New techniques are being used, such as three-dimensional conformal radiotherapy, intensity-modulated radiation therapy and stereotactic techniques that require next-generation linear accelerators and significant computer support.

For high-grade gliomas, the treatment that has shown greater survival is the combination of surgery, radiation therapy (at a greater dose than in low-grade gliomas) and chemotherapy. The postoperative treatment component that has been shown to have the greatest benefit is radiation therapy.

Tailored cellular vaccines against the most aggressive brain tumours

The Clínica is the only centre in Spain that has conducted a study for the treatment of glioblastomas with immunotherapy. The new therapy, which is administered to participating patients in the form of vaccines, is combined with standard first-line treatment. It consists of the surgical extirpation of the tumour, followed by the administration of radiation therapy and chemotherapy with temozolomide.

The immune system is essential in the development and management of tumours. The objective of immunotherapy is to repair or increase the patient’s immune system response.

Limited disease and the combination of immunotherapy and chemotherapy make this a good added option to the treatment of patients with glioblastoma.

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