[Present status and future prospects of multi-disciplinary therapy for malignant gliomas]

The prognosis of malignant gliomas is poor. The 5-year survival rate of patients with glioblastomas is still less than 10%. It is difficult to cure this disease by a single treatment modality, and thus, the use of multi-disciplinary therapy mainly comprising surgery, radiotherapy, and chemotherapy is necessary. Malignant gliomas invade the adjacent brain tissue; however, it is well known that greater the extent of tumor resection better is the prognosis. Maximal resection is very important, and various procedures such as intraoperative navigation, evoked potential, photodynamic diagnosis, intraoperative magnetic resonance imaging (MRI), and awake surgery are performed to preserve speech and motor function in patients. According to a phase III trial by the European Organization for Research and Treatment for Cancer (EORTC), the standard therapy for glioblastomas is radiotherapy with concomitant administration of temozolomide; however, the median survival time is only 14.6 months. Multi-institutional, cooperative trials are necessary for the development of more effective and safe standard therapy.