Glioblastoma, or GBM for short, is known as the “king of human cancers”. The average survival time for GBM patients is about 15 months. In August 2025, I attended the Chinese Congress of Neurosurgery held in Suzhou, where I carefully listened to several experts’ presentations on the latest research about glioblastoma. This led me to a key question: how can GBM patients achieve long-term survival?

While treating peripheral lung cancer with the CyberKnife, I found that when the tumor receives an extremely high radiation dose, it almost never recurs. This made me wonder — if we apply a high radiation dose to glioblastoma, could we delay tumor recurrence?

Through continuous study of GBM patients’ recurrence patterns, their physical and mental states, sleep quality, limb movement, and different treatment approaches, I discovered some clues to the “code” for long-term survival. During the growth (or recurrence) process of GBM, the tumor often grows in a leap-like pattern — once its diameter exceeds 2–3 cm, it can expand rapidly in a short time. If we can deliver high-dose, precise radiotherapy at the early stage of recurrence, combined with bevacizumab, the tumor can be eliminated before it takes hold. Similarly, after surgery, applying CyberKnife treatment combined with conventional radiotherapy and increasing the total radiation dose can also help delay recurrence.

The following is a case of GBM I treated earlier.

In September 2017, the patient developed weakness in the left limbs. MRI showed a tumor in the right thalamic lateral (trigonal) region. In January 2018, the tumor was surgically removed at Huashan Hospital. Pathology confirmed GBM (WHO grade IV) with IDH1/2 wild-type, TERT mutation, TP53 mutation, and weakly positive MGMT.

I designed a treatment plan combining CyberKnife and radiotherapy, administered concurrently with temozolomide chemotherapy. After completing radiotherapy, the patient continued chemotherapy and underwent enhanced MRI follow-up every two months. Fifteen months after surgery, a small recurrence was detected; I performed CyberKnife treatment again combined with bevacizumab, followed by regular follow-ups.

After two rounds of high-dose CyberKnife radiation, the patient developed radiation-induced brain injury, which was managed with 2–3 courses of bevacizumab annually to reduce the damage. The patient has since maintained a high quality of life—although there is mild weakness in the left leg, the patient remains able to walk independently. Following my treatment strategy, the patient has maintained a positive mindset, good nutrition, adequate sleep, and regular exercise, all of which help sustain strong immunity and resistance.

As of now, the patient has survived for seven and a half years. The most recent MRI shows radiation-induced brain injury, but her symptoms have not worsened.