The Treatment of Glioblastoma Multiforme of the Brain

T HERE is n o sat isfactory t r e a t m e n t of glioblastoma mult i forme of the brain. However , as we are constant ly conf ron ted with the problem of how best to deal wi th the unfor tuna te pat ients suffering f rom these tumors , we mus t constant ly str ive to improve our therapeut ic methods. Dur ing our experience with this t umor over the last ~0 years, we have been impressed b y several appa ren t facts. The surgical mor ta l i ty ra te has been dramatical ly reduced; the pos topera t ive course has become much smoother ; the condition of m a n y of our pa t i en t s has been strikingly improved following operat ion; and there have been a n u m b e r of pa t ients who have lived much longer and in a much bet ter condition than had been anticipated. Obvious ly no single factor is responsible for the be t te r results achieved today. I t was our impression, however, t ha t the improvem e n t in the immedia te and late postoperat ive course resulted in large measure f rom the adop t of a policy of ext i rpat ing glioblast omas as completely as possible. In this s tudy , we have a t t empted to determine whe the r radical extirpation of these tumors is the best course and exactly what our resuits have been. T h e concept of radical excision for gliob la s tomas is not universally accepted. The late Ernes t Sachs 7 always advoca ted this course. Kenne th McKenzie a stressed the va lue of achieving an internal decompress ion b y removing as much of the t umor