Glioblastoma (GBM) is the most common and malignant tumor among the neoplasms of the central nervous system. It originates in the glia cells, responsible for supporting the cells of the nervous system. It is fast growing and can manifest itself at any age, although it is more frequent in adults. Due to their malignancy, they are tumors with a poor prognosis. Its incidence is very low, not exceeding 2-3 cases per 100,000 inhabitants.
The exact causes of glioblastoma are unknown. It may develop from a diffuse astrocytoma or from an anaplastic astrocytoma (secondary glioblastomas), but in most cases it occurs de novo, without any evidence of previous neoplasia.
At the moment, ionizing radiation is the only unequivocal risk factor identified for glial and meningeal tumors. Studies conducted indicate that skull radiation, even at low doses, can increase the risk of glial tumors, with a latency period of up to 20 years after exposure.
Other factors may also contribute to the development of the disease:
- Diseases of genetic origin that predispose to tumor formation such as neurofibromatosis type 1 and type 2, Lynch syndrome, Turcot syndrome and Li-Fraumeni syndrome.
- Although it can develop at any time, it is more frequent after 45 years of age.
- Sex, being somewhat more frequent in men than in women.
Because glioblastomas can grow rapidly, the most common symptoms are usually caused by increased pressure in the brain. These symptoms may include headache, nausea, vomiting and drowsiness. In addition, seizures, progressive cognitive dysfunction, personality changes, behavioral changes and memory loss may occur.
Depending on the location of the tumor, patients may develop a variety of symptoms such as weakness on one side of the body, memory loss and/or speech difficulties and visual changes.
There is no total preventive measure for the development of glioblastomas, however, in some cases avoiding modifiable risk factors may help to reduce it. At the moment, the only identified risk factor clearly associated with the development of these tumors is exposure to ionizing radiation.
Exposure to this type of radiation can occur by different routes:
- Internal exposure: occurs when the radionuclide is inhaled, ingested or injected.
- External exposure: occurs when the radioactive material is present in the environment.
The people most exposed to this type of radiation are astronauts (from cosmic radiation), X-ray medical personnel, researchers and radioactive facility personnel. In addition, additional exposures may be received at each X-ray and nuclear medicine examination.
13.5 million variants
Melin BS, Barnholtz-Sloan JS, Wrensch MR, et al. Genome-wide association study of glioma subtypes identifies specific differences in genetic susceptibility to glioblastoma and non-glioblastoma tumors. Nature Genetics. 2017 May;49(5):789-794.
Louis DN, Perry A, Wesseling P, et al. The 2021 WHO Classification of Tumors of the Central Nervous System: a summary. Neuro Oncol. 2021 Aug 2;23(8):1231-1251.