Concluding Remarks and Perspectives for Future Research

Abstract

After early reports of the usefulness of postoperative radiotherapy (RT) in improving survival outcomes of Glioblastoma (GB) after surgery [ 1 , 2 ], the almost unanimous opinion in the oncology community at present is that the most signifi cant, recent improvement in the prognosis of GB patients is due to Temozolomide (TMZ) chemotherapy (CHT). The results of the well-known EORTC/NCIC phase III trial have shown, in fact, better outcomes with TMZ CHT concurrently and sequentially delivered, as compared to postoperative RT only; that is, there is a higher median (14.6 vs. 12.1 months) and 2-year survival (26.5 % vs. 10.4 %), with a 37 % decrease of risk-of-death [ 3 ]. However, the above results should be critically considered, in light of the subsequent reports of large database collections (Patterns-of-Care Studies) also showing a highly signifi cant role and deep impact of modern conformal radiation therapy (3D-CRT) on prognosis, a result that cannot be demonstrated as the yield of random studies, for obvious ethical reasons. In a comparison between two large series of GB patients collected over subsequent periods (633 cases,