(1) Background: Glioblastoma is the most frequent and lethal primary tumor of the central nervous system. Through many years, research has brought various advances in glioblastoma treatment. At this time, glioblastoma management is based on maximal safe surgical resection, radiotherapy, and chemotherapy with temozolomide. Recently, bevacizumab has been added to the treatment arsenal for the recurrent scenario. Nevertheless, patients with glioblastoma still have a poor prognosis. Therefore, many efforts are being made in different clinical research areas to find a new alternative to improve overall survival, free-progression survival, and life quality in glioblastoma patients. (2) Methods: Our objective is to recap the actual state-of-the-art in glioblastoma treatment, resume the actual research and future perspectives on immunotherapy, as well as the new synthetic molecules and natural compounds that represent potential future therapies at preclinical stages. (3) Conclusions: Despite the great efforts in therapeutic research, glioblastoma management has suffered minimal changes, and the prognosis remains poor. Combined therapeutic strategies and delivery methods, including immunotherapy, synthetic molecules, natural compounds, and glioblastoma stem cell inhibition, may potentiate the standard of care therapy and represent the next step in glioblastoma management research.

The purpose of this study was to analyze and discuss the clinical characteristics, long-term outcome, and prognostic factors of cerebellar strokes treated in a single health care facility in Mexico. We retrospectively reviewed the medical records of adult patients admitted to our hospital with diagnosis of cerebellar ischemic and hemorrhagic stroke between 2018 and 2020. Baseline data included sociodemographic and radiological variables, treatment (surgical versus conservative), and Glasgow Coma Scale on arrival (GCSOA). The final neurological outcome was evaluated with the Glasgow Outcome Scale (GOS) six months after hospital discharge. Ten patients (seven male and three female) with a mean age of 57.9 ± 9.3 years were included, six with cerebellar ischemic infarction and four with cerebellar hemorrhage. Out of the 10 patients, four underwent surgery (suboccipital decompressive craniectomy {SDC} ± ventriculostomy). The outcome was favorable in four cases (40%) and unfavorable in six (60%). Patients who underwent surgical treatment fared worse with all four cases associating poor outcome. The comparison between good and poor outcome groups showed significant differences in the presence of obstructive hydrocephalus (one versus six, p = 0.05) and poorer GCSOA (6.16 ± 1.72 versus 12.5 ± 3.6, p = 0.05), associating poorer outcome. There is still controversy regarding the appropriate management of cerebellar strokes. The presence of obstructive hydrocephalus and poorer GCSOA are associated to worse outcomes.

Seventy years ago, Robin Mole introduced the concept of the abscopal effect to describe a rare phenomenon. This occurs when local radiation triggers an immune-mediated reduction in tumors outside the treated area but within the same organism. Observing this effect has been linked to improved overall and progression-free survival in patients who experience it. While the abscopal effect was once considered rare, it is now being observed more frequently due to the combination of radiation with immunotherapy. As a result, more researchers are exploring this study area, which shows promise for excellent results. This review focuses explicitly on the immunological implications of activating the abscopal effect through ionizing radiation in the central nervous system and explores the potentially involved immunological pathways.

Background: Primary central nervous system lymphoma (PCNSL) remains a diagnostic challenge due to its radiological overlap with other brain lesions and limitations of stereotactic biopsy, particularly following corticosteroid exposure. Interleukin-10 (IL-10) is a cytokine frequently elevated in PCNSL and has emerged as a potential diagnostic biomarker, yet reported cut-off values vary widely, limiting clinical application. Objective: To determine the diagnostic accuracy of CSF IL-10 for differentiating PCNSL from other brain lesions by estimating the optimal cut-off, sensitivity, specificity, and area under the receiver operating characteristic (ROC) curve (AUC), and to explore its potential prognostic value. Materials and methods: We conducted a retrospective observational study of 115 patients who underwent lumbar puncture for diagnostic workup of brain lesions at a tertiary referral center between 2015 and 2020. CSF IL-10 levels were measured using a standardized enzyme-linked immunosorbent assay (ELISA) protocol. Patients with prior corticosteroid use, HIV infection, insufficient CSF, or lacking a definitive diagnosis were excluded. Diagnostic performance was assessed via ROC analysis. The association between CSF IL-10 and progression-free survival (PFS) was explored in patients with histologically confirmed PCNSL receiving standard therapy. Results: Sixty-three patients were diagnosed with PCNSL, and 52 with alternative pathologies, including gliomas, demyelinating diseases, and infections. The mean CSF IL-10 level was significantly higher in PCNSL patients (109.9 pg/mL) compared to non-PCNSL (12.6 pg/mL). Using a cut-off of 20.05 pg/mL, CSF IL-10 showed a sensitivity of 93.7% (95% CI: 84.8-97.5%) and specificity of 88.5% (95% CI: 77.0-94.6%), with an AUC of 0.95 (95% CI: 0.91-0.99). The positive predictive value was 90.8% and the negative predictive value was 92.0%. Higher IL-10 levels were modestly correlated with shorter PFS (R2 = 0.315, p < 0.015). Conclusions: CSF IL-10 quantification may serve as a minimally invasive, high-yield adjunct in the diagnosis of PCNSL, particularly when biopsy is delayed or contraindicated. However, as both the diagnostic cut-off and prognostic correlation were derived from the same retrospective cohort, prospective validation is essential prior to clinical adoption.

The mean survival duration of patients with glioblastoma after diagnosis is 15 months (14-21 months), while progression-free survival is 10 months (+/- one month). Although there are well-defined overall survival statistics for glioblastoma, individual survival prediction remains a challenge. Therefore, there is a need to validate an accessible and cost-effective prognostic tool to provide valuable data for decision-making. This study aims to calculate the mean survival of patients with glioblastoma at a tertiary-level hospital in Mexico using the online glioblastoma survival calculator developed by researchers at Harvard Medical School & Brigham and Women's Hospital and compare it with the actual mean survival. We conducted a retrospective observational study of patients who received a histopathological diagnosis of glioblastoma from the National Institute of Neurology and Neurosurgery "Manuel Velasco Suárez" between 2015 and 2021. We included 50 patients aged 20-83 years, with a tumor size of 15-79 mm, and who had died 30 days after surgery. Patient survival was estimated using the online calculator developed at Harvard Medical School & Brigham and Women's Hospital. The estimated mean survival was then compared with the actual mean survival of the patient. A two-tailed equivalence test for paired samples was performed to conduct this comparison. A value of p < 0.05 was considered significant. The mean age of the sample was 55.5 years (confidence interval (CI) 95%, 52.61-58.71). The mean tumor size in our sample was 49.12 mm (±14.9mm). We identified a difference between the mean estimated survival and the mean actual survival of -1.37 months (CI 95%; range of -3.7 to +0.9). After setting the inferior (IL) and superior limits (SL) at -3.8 and +3.8 months, respectively, we found that the difference between the mean estimated survival and the actual mean survival is within the equivalence interval (IL: p = 0.0453; SL: p = 0.0002). The actual survival of patients diagnosed with glioblastoma at the National Institute of Neurology and Neurosurgery was equivalent to the estimated survival calculated by the online prediction calculator developed at Harvard Medical School & Brigham and Women's Hospital. This study validates a practical, cost-effective, and accessible tool for predicting patient survival, contributing to significant support for medical and personal decision-making for glioblastoma management.

Sellar and parasellar tumors occupy a compact neurovascular region where millimetric differences in extension determine whether an effective dose is deliverable while preserving vision, endocrine function, and hypothalamic and cranial-nerve function. Evidence for choosing among single-fraction stereotactic radiosurgery (SRS), hypofractionated stereotactic radiotherapy in three to five fractions (hfSRT), and conventionally fractionated precision radiotherapy (cfRT) is fragmented, largely retrospective, and heterogeneous in visual and toxicity reporting. This structured narrative review integrates evidence for pituitary neuroendocrine tumors, craniopharyngiomas, and sellar or parasellar meningiomas, prioritizing guidelines, systematic reviews, multicenter cohorts, and studies with quantitative visual outcomes. Indication depends on histology and behavior; modality selection depends on target volume, optic contact, canal involvement, pathway deformation or encasement, temporal stability, previous treatment, and achievable coverage. Single-fraction SRS suits compact, stable targets coverable within organ-at-risk limits; hfSRT can improve deliverability for focal peri-optic interfaces; and broad contact, large or irregular targets, dynamic cystic anatomy, pediatric disease, and complex multi-organ geometry favor cfRT. Automated perimetry and optical coherence tomography (OCT) provide complementary functional and structural measures; isolated OCT change cannot alone diagnose radiation-induced optic neuropathy. We propose an anatomy-based framework weighing target coverage and functional risk together; it synthesizes observational evidence and is not prospectively validated.