ABSTRACT
Glioblastoma multiforme is characterized by persistent recurrent course despite surgical, radio- and chemotherapeutic treatment. The outcomes of superselective intra-arterial administration of bevacizumab with blood-brain barrier disruption in patients with recurrent glioblastoma have been published. The authors reported significant increase in overall survival (up to 2.5 years). We report treatment of recurrent glioblastoma in a young patient with progressive course of disease despite 4 previous neurosurgical interventions, radiotherapy and first-line chemotherapy. Superselective intra-arterial administration of bevacizumab with blood-brain barrier disruption made it possible to achieve clinical response and improve neurological status.
Subject(s)
Brain Neoplasms , Glioblastoma , Glioma , Bevacizumab , Blood-Brain Barrier , Brain Neoplasms/diagnostic imaging , Brain Neoplasms/drug therapy , Glioblastoma/diagnostic imaging , Glioblastoma/drug therapy , Glioma/diagnostic imaging , Glioma/drug therapy , Humans , Neoplasm Recurrence, Local/drug therapyABSTRACT
OBJECTIVE: A systematic review of the world literature data on surgical management and preoperative screening of cancer patients within the COVID-19 pandemic, as well as prevention of SARS-CoV-2 transmission and resumption of elective surgery. MATERIAL AND METHODS: Literature data searching included Pubmed, MedLine, Scopus, Web of Science, and RSCI databases. We enrolled literature data published for the period from March 2020 to June 2020. RESULTS: Retrospective and prospective clinical trials have been analyzed. The review ensures up-to-date data on surgical management of cancer patients under the pandemic, recommendations for resuming the elective surgery, preoperative screening and prevention of COVID-19. CONCLUSION: To date, the COVID-19 pandemic is still not resolved, and infection continues spreading around the world. Thus, there is an urgent need for more thorough research of the strategies for mitigating the effects of pandemic. To date, the recommendations for optimal surgical management of cancer patients within the pandemic are still actively developed considering the benefits of treatment and risks of SARS-CoV-2 infection. Resumption of elective surgery should be progressive and cautious, especially in pandemic areas. For safety reasons, all patients eligible for surgical treatment should be carefully selected according to stratification of risk factors. Thorough preoperative screening, monitoring of symptoms of infection, and use of appropriate adapted personal protective equipment are extremely important.
