2Department of Radiation Oncology, Memorial Şişli Hospital, İstanbul-Türkiye
3Department of Radiation Oncology, Acıbadem University Faculty of Medicine, İstanbul-Türkiye
4Department of Radiation Oncology, Medicana Ankara Hospital, İstanbul-Türkiye DOI : 10.5505/tjo.2025.4511 OBJECTIVE
Glioblastoma is the most common primary brain tumor with a poor prognosis. Despite the guidelines, treatment management in elderly or progressing patients may be scarce. Our objective was to determine the current clinical practice patterns for glioblastoma management through a nationwide survey.
METHODS
Different scenarios and situations were prepared for a web-based online questionnaire emailed to radiation
oncologists.
RESULTS
A total of 195 radiation oncologists responded to the survey. There was a consensus for concurrent
adjuvant chemoradiotherapy for patients younger than 70 years old with good performance. However,
physicians disagreed on the course of adjuvant temozolomide, whereas they administered the chemotherapy
six courses (44%), 12 courses (34%), or until progression (19%). For patients older than 70
years and with good performance, most physicians (80%) preferred the standard treatment approach.
However, standard approaches differed among the physicians for older adults with poor status, and
diverse strategies were recommended for managing this patient group. Stereotactic approaches (73%)
are recommended for reirradiation in progression. The systemic treatment recommendation was bevacizumab
(87%) in the patient who progressed after standard chemoradiotherapy. Surgery was requested
for younger patients who have good performance and small tumors. In symptomatic radionecrosis,
steroids, bevacizumab, and surgery were the alternatives, respectively.
CONCLUSION
Physicians take different approaches to treatment, such as adjuvant chemotherapy cycles in younger
patients, radiotherapy schemes in older adults, and treatment choices for progression. Despite the continuing
investigations in high-grade gliomas, it may be suggested that the guidelines include detailed
clinical scenarios for optimal management.