What is the role of carmustine-polymer wafers (Gliadel) in the treatment of recurrent glioblastoma multiforme (GBM)?

Updated: Jul 28, 2021
  • Author: Jeffrey N Bruce, MD; Chief Editor: Herbert H Engelhard, III, MD, PhD, FACS, FAANS  more...
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Answer

Carmustine-polymer wafers (Gliadel) were approved by the FDA in 2002. Gliadel wafers are placed on the surface of the resected tumor bed. Though Gliadel wafers are used by some for initial treatment, they have shown only a modest increase in median survival over placebo (13.8 vs. 11.6 months) in the largest such phase III trial, and are associated with increased rates of cerebrospinal fluid leak and increased intracranial pressure secondary to edema and mass effect. [94, 95] Carmustine wafers increased 6-month survival from 36% to 56% over placebo in one randomized study of 222 patients, though there was a significant association between the treatment group and serious intracranial infections. [96, 97]


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