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Glioblastoma (also known as glioblastoma multiforme) is a malignant intrinsic tumor thought to arise from populations of stem/progenitor cells in the brain. It is the most common aggressive intrinsic brain tumor in adults, with the potential to spread rapidly within the brain. Patients with glioblastoma face a poor prognosis, with median overall survival of approximately 15 months. However, our growing understanding of the molecular biology of gliomas means that this outlook may be improving. The identification of clinically relevant subgroups defined by specific genetic mutations is challenging the traditional delineation between low- and high-grade gliomas that has been based on histological appearance and imaging. Indeed, it is becoming clear that, as a molecular entity, a glioblastoma, which by traditional classification is a grade IV glioma, may present with a lower grade initially and then become more aggressive – an important addition to the established concept. The care of a patient with a glioblastoma requires a coordinated approach delivered by a multidisciplinary team, with the aim of maintaining quality of life for as long as possible. Here, we provide a concise overview of the diagnosis and management of glioblastoma, as well as discussion of our emerging understanding of the molecular drivers that are helping us to delineate different patient subgroups. These subgroups will, hopefully, allow more targeted treatments in the future. This resource will be of interest to all those involved in caring for patients with this aggressive brain tumor, including neurologists, neurosurgeons, neuro-oncologists, radiation oncologists, palliative care specialists, specialist nurses and medical students. Contents: • Epidemiology, pathophysiology and classification • Clinical presentation • Diagnosis • Management • Treatment of associated conditions • Emerging research and treatment

Though the treatment of central nervous system (CNS) tumors has been challenging, new advances have helped us better understand the molecular and genetic makeup of many tumor types, and new chemotherapies and immunotherapies have extended survival in patients with aggressive primary CNS tumors. This book discusses pediatric and adult tumors of the CNS, the classification schemes used to categorize them, advances in surgical techniques, and several important genetic alterations found in these tumors. We hope this book contributes to the reader’s understanding of these tumors and provides the most up-to-date and cutting-edge discoveries in this exciting field.

Central nervous system (CNS) tumors are the eighth leading cause of cancer death and the second most common childhood cancer worldwide. Current treatment methods include surgery, radiation therapy, chemotherapy, targeted therapy, immune therapy etc. However, patients with CNS tumors usually have an unsatisfactory prognosis accompanied by impaired neurologic functions when compared with other cancers. Few drugs or treatments have been proven effective in CNS tumors due to the presence of blood-brain barriers and its distinctive tumor microenvironment.

This is truly an exciting time in the field of neuro-oncology, particularly in the area of hi- grade gliomas. The management of patients with high-grade gliomas has historically been one of the most challenging and disheartening fields in medicine, where failure is the rule and longevity is the exception. The jaded often state that despite purported advances in surgical and radiotherapeutic techniques and a myriad of clinical trials of medical therapies, the s- vival statistics for glioblastoma have not changed in the last three decades. The nihilism associated with these tumors is such that some practitioners still advise against treatment or even biopsy, recommending palliative care with the diagnosis based only on history and an MRI scan. If the current state-of-the-art in the diagnosis and management of high-grade gliomas was truly so bleak, there would be no reason to compile and publish a monograph on the subject. The fact is that we have recently entered an era where real progress is being made in our understanding and treatment of high-grade gliomas that is directly benefiting some patients. We are slowly but surely chipping away at this problem. One approach has exploited correlations between particular molecular markers and therapeutic response. The first such “breakthrough” in high-grade glioma was the observation that loss of chromosomes 1p and 19q uniformly predict chemosensitivity in anaplastic oligodendrogliomas (1).

This book encompasses a number of articles that focus on the molecular blueprint of brain tumors. A collection of relevant papers in the rapidly expanding field of brain tumor molecular genetics broadens our knowledge about the biology of brain tumors, and inspires further studies that will improve the diagnosis and clinical management of brain tumors. Due to the great heterogeneity of brain tumors it is important to research and understand every aspect of their initiation, progression and metastasis in order to design better diagnostic and therapeutic approaches for their clinical management and patient benefit.

This book serves as a comprehensive guide to the rapidly evolving field of molecular neuropathology of nervous system tumors, as well as the underlying biology and emerging molecular targeted therapies. Special emphasis is given to already established and emerging molecular diagnostic tests in neuropathology, as well as molecular targeted therapies. The book is organized by clinico-pathologic disease entities, and each chapter is written by a team of experts in their field. Molecular Pathology of Nervous System Tumors is of great value and utility for physicians and scientists involved with or interested in the up-to-date diagnosis and treatment of patients with brain tumors.

This is a multi-specialty book on the diagnosis, evaluation, and treatment of CNS metastases of the brain and spine. Written by renowned experts in their fields, the book covers essential contemporary topics in CNS metastases care. The book is divided into seven parts that begin with chapters that cover the fundamental biology of disease so that subsequent chapters on imaging, diagnosis, treatment, and palliation can be properly contextualized. This text also provides a framework for understanding the biology of radiation therapy so that radiation treatment options of the brain and spine can be more fully understood. New medications and technologies are reviewed from the perspective of maximizing efficacy and minimizing toxicity, independently and as combinatorial therapy. Central Nervous System Metastases: Diagnosis and Treatment serves as a practical reference for health care providers and trainees. It provides the comprehensive, detailed perspective required to provide holistic care to patients with metastatic disease to the brain and spine.