The glioblastoma multiforme: a lifelong challenge to the neurosurgeon

During a period of 34 years 1316 gliomas of the brain have been treated, among them 508 glioblastomas (= 39%). In addition to the operative removal and postoperative X-ray therapy of glioblastomas various attempts have been undertaken to prevent recurrences: Intracerebral application of Cobalt60 (6 patients); locally applied antimitotic agents (76 patients); bacterial liquefaction induced by intracarotid administration of Clostridium butyricum M 55 spores ("Oncolysis", 67 patients); circumscribed heating of the extirpation cavity with metal and high-frequency electromagnetic field (85 patients); vaporization of the tumour bed with the defocussed CO2- or Neodymium-YAG-Laser beam (177 patients). Permanent cure has been attained only in single cases so that the problem does not yet seem to be definitely solved by any of these methods. However, bacterial oncolysis in combination with the periodic postoperative generation of heat locally in the excision cavity of the tumour, might justify cautious optimism about future developments.