Long-Term Survival in Glioblastoma With High-Adherence Tumor Treating Fields Therapy: A Case Report

Background: Glioblastoma multiforme remains the most aggressive primary brain malignancy in adults, and accounts for approximately 50% of all primary malignant brain tumors. It is unfortunately associated with a poor prognosis, with most patients dying within 5 years of diagnosis.

Case Presentation: We report a 69-year-old male diagnosed with left frontal glioblastoma, IDH-wildtype, WHO grade 4. Molecular analysis demonstrated MGMT promoter methylation and EGFRvIII expression. The patient underwent gross total resection followed by concurrent radiotherapy with temozolomide and subsequent adjuvant temozolomide for one year, in addition to tumor treating fields (TTFields) therapy administered for 18 hours daily. Imaging at seven months suggested radiographic progression, prompting repeat resection; pathology demonstrated treatment-related necrosis without viable tumor. The patient has remained radiographically stable for over five years following diagnosis with minimal residual neurologic deficit.

Conclusion: This case highlights the potential for prolonged survival in elderly patients with glioblastoma treated with standard chemoradiation and consistent use of TTFields therapy. TTFields therapy remains largely underutilized in the treatment of glioblastoma multiforme (GBM), with only a small percentage of eligible patients receiving treatment despite the proven survival benefit and guideline support. Adoption of therapy is limited by provider hesitancy, low patient awareness, treatment burden, functional limitations, and social barriers. Real-world data demonstrated suboptimal adherence, with declining compliance over time, although survival outcomes are strongly dose-dependent and significantly improved with >75% usage. Early discontinuation is associated with worse overall survival. Addressing these barriers and improving adherence represent actionable strategies to enhance population-level outcomes in GBM.