From the Guidelines
Patients with glioma should be evaluated by a specialized multidisciplinary team, and treatment plans should prioritize tumor resection, fractionated focal radiotherapy, and concomitant and adjuvant temozolomide chemotherapy to improve median and 2-year survival, as recommended by the most recent guidelines 1. When considering treatment options for glioma patients, it is essential to take into account the patient's performance status, neurological function, and tumor characteristics.
- Tumor resection is a crucial step in the treatment process, as it can help improve prognosis and may be beneficial in attempting maximal tumor resection 1.
- Fractionated focal radiotherapy (60 Gy, 2 Gy · 30, or equivalent doses/fractionations) is the standard treatment after resection or biopsy, with hypofractionated regimens (e.g., 40 Gy in 15 fractions) proposed for elderly patients or those with low performance status 1.
- Concomitant and adjuvant temozolomide chemotherapy has been shown to significantly improve median and 2-year survival in glioblastoma patients, with the selection of patients likely to benefit from therapy based on MGMT gene promoter methylation status 1. Key considerations in treatment planning include:
- Patient age and performance status
- Tumor grade and histology
- Neurological function and potential for toxicity
- Goals related to health-related quality of life (HRQOL) By prioritizing these factors and following the most recent guidelines, healthcare providers can develop effective treatment plans that improve patient outcomes and reduce morbidity and mortality 1.
From the Research
Gli 1 Er Visits
- The term "Gli 1" is associated with the Glioma-associated homologue-1 (GLI-1) gene, which plays a role in the sonic hedgehog signalling pathway and is important for proliferation, migration, invasion, growth, and angioinvasion, and cancer stem cell self-renewal in various malignancies 2.
- However, in the context of "er visits," it is possible that "Gli 1" refers to Glucagon-Like Peptide-1 (GLP-1) receptor agonists, which are used to treat type 2 diabetes and obesity.
- GLP-1 receptor agonists have been shown to improve glucose control and promote weight loss, but they can also cause adverse events such as gastrointestinal symptoms, pancreatitis, and biliary disease 3.
- Emergency clinicians should be aware of the indications and potential complications of GLP-1 agonist therapy to provide appropriate care for patients who may be taking these medications 3.
- There is no direct evidence to suggest that GLI-1 or GLP-1 receptor agonists are specifically related to emergency room visits, but patients taking these medications may require medical attention for related adverse events 4, 3.