Erazo-Valle-Solís AA, Juárez-Ramiro A, Mora-Pérez J, Cervantes-Sánchez MG, Fernández-Orozco A, Gil-Ortiz-Mejía C, Plácido-Méndez AM, Plascencia-Álvarez N, Valdez-Orduño R, Núñez-Guardado G, Ceja-García JP, Cruz-López JC, Enríquez-Aceves MI, Figueroa-Martínez P, Flores-Anaya N, González-Vela JL, Guerrero-Maldonado A, Hernández-Hernández CA, Hernández-Luis GN, Landa-Fernández AM, Murillo-Medina K, Padilla-Ponce I, Serna-Camacho ME

Language: Spanish
References: 99
Page: 110-130
PDF size: 1599.80 Kb.

ABSTRACT

Introduction: Glioblastoma multiforme (GBM) is a Central Nervous System (CNS) tumor with an unfavorable prognosis and survival less than 10 months. In the last decade, important advances have been made in its pathophysiology, diagnosis and treatment, which have modified the life expectancy of these patients. In Mexico there is limited information about the new paradigms of treatment of this disease.
Objective: To analyze the evidence on the epidemiology, diagnosis and treatment of GBM for the creation of internal recommendations of the ISSSTE, since there is a greater access to medicines and novel treatment therapies.
Materials and Methods: The SOISSTE convened a meeting where physicians with different specialties and experience in the management of GBM provided current information in the treatment and diagnosis of this pathology, in order to provide a document of support and guidance in its management. The recommendations in this review were made through the GRADE system.
Results: A multidisciplinary treatment is recommended since it presents an effect in survival free of recurrence. The use of anti-angiogenic drugs (bevacizumab) should be evaluated in the presence of recurrence. Persistence and/or progression in hospitals that have these resources. It is advised to implement this treatment after a standard treatment in patients with Performance Score (PS) ›70, ECOG (East Cooperative Oncology Group) 0-1 and molecular proneural subtype.
Conclusions: The diagnosis and treatment of GMB should be individualized based on the resources of each site. It must be multidisciplinary. The determination of HDI1 by immunohistochemistry is recommended, as well as the molecular profile, to achieve an overall survival impact with the use of bevacizumab in this group of patients

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