Technological innovations in diagnosis and treatment of glioblastoma

Patients with a glioblastoma (GBM), the most aggressive type of brain tumor, are presented with a dismal prognosis. In this thesis, several innovations in the diagnosis and treatment of GBM are investigated. Part I considers methods to monitor and predict treatment response which can be included into clinical decision support systems such as a CT radiomics signature, which are developed in order to aid physicians and patients to choose an optimal treatment strategy. Part II discusses relevant technical aspects of 7 Tesla MRI for GBM and the necessary steps to integrate this into radiation treatment planning. In Part III treatment aspects, specifically the safety of autophagy inhibition through the addition of chloroquine to chemoradiation for GBM in a phase Ib trial, are discussed. A daily dose of 200 mg chloroquine was determined as the maximum tolerated dose when combined with radiotherapy and concurrent temozolomide. EGFRvIII was identified as a potential predictive biomarker.