Dear Colleagues,

In 2005, the EORTC (European Organisation for Research and Treatment of Cancer) 26981-NCI Canada CE3 Phase III Trial in Glioblastoma was published and demonstrated that the addition of an oral chemotherapy drug Temozolomide to standard radiation therapy resulted in a doubling of two year survival (Stupp, et al., 2005). An update of the study in 2009 has confirmed that almost 10% of patients are alive at 5 years post diagnosis.

The promising outcome in this study subsequently led to a greater emphasis on optimizing outcome and research in patients with high grade glioma; not only for systemic therapy options, but also with in regards to molecular neuropathology, diagnostic procedures, neurosurgical care, radiotherapy delivery and supportive care. These include more aggressive neurosurgical resection utilizing awake craniotomy, MRI guidance or endoscopic resection; sophisticated radiation therapy techniques such as Intensity Modulated Radiation Therapy; and enrolment of patients into clinical trials utilizing targeted therapies in addition to temozolomide. Demand for more supportive care services through neuro-oncology tumour boards and cancer care coordinators have also expanded in response to the perceived improved outcome and complexity of care following the introduction of multidisciplinary care.

Although clinical trials over the subsequent fifteen years since the initial EORTC 26981-NCI Canada CE3 publication have not produced a major change to the treatment protocol for glioblastoma; the quality initiatives that have resulted along the whole patient management pathway have provided further incremental improvements in median survival. This has been not just for those diagnosed with glioblastoma, but also for anaplastic glioma and other primary CNS tumours. Such improvements have allowed more effective patient selection for therapies, less morbidity from interventions and a better understanding of disease natural history.

This Special Issue will highlight potential multidisciplinary technical and supportive care initiatives that may optimize the current management of patients with high grade glioma in the future and thus further improve upon patient care and outcomes.

Stupp, R.; Mason, W.P.; van den Bent, M.J.; Weller, M.; Fisher, B.; Taphoorn, M.J.B.; Belanger, K.; Brandes, A.A.; Marosi, C.; Bogdahn, U.; et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N. Engl. J. Med. 2005, 352, 987–996.

Assoc. Dr. Michael Back
Guest Editor

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• High grade glioma
• glioblastoma
• neuro-oncology
• Seizures