What is the best treatment for grade 4 glioblastoma multiforme (gbm)?

Depends: If surgery is possible, that is the best, followed by radiation with temodar (temozolomide) (chemotherapy), followed by temodar (temozolomide) and Avastin (chemotherapy). Alternatively enrollment in a clinical trial for post surgery treatment may be better (or worse).

Multimodal treatment: The treatment depends on the location and size and neurological status. In the ideal situation, the best treatment is > 90% surgical resection followed by concurrent radiation therapy and chemotherapy (temodar). This is then followed and at the time of recurrence, fda approved treatments include Avastin (bevacizumab) and novocure(electric field therapy).Clinical trial are also helpful and should be investigated.

Sgy,Xrt,ctx: Remove as much as possible and then follow up with radiation and pill form chemotherapy. Some additional infusion all ctx can be used also. Temazolamide and about six weeks of radiation are standard. Avastin (bevacizumab) shows promise as well.