Carmustine wafers (Gliadel) and temozolomide (Temodal) were recently approved 
for initial management of glioblastoma. Gliadel) is a polymer wafer containing 
carmustine. These wafers are designed to be placed in the surgical cavity after 
glioblastoma resection to deliver local chemotherapy. This treatment is intended 
for tumors for which gross total resection is possible. Temozolomide is 
administered concomitantly with radiotherapy for six weeks followed by six 
cycles of adjuvant temozolomide (EORTC 26981, also known as "Stupp's protocol"). 
Temozolomide administered according to this protocol produced a median survival 
benefit of 2 months in glioblastomas, and carmustine a similar benefit in 
high-grade gliomas. The two-year survival rate was 26.5% with radiotherapy plus 
temozolomide compared with 10.4% with radiotherapy alone. In patients with 
complete resection, two-year survival reached 38%. These two new treatments are 
essentially intended for patients younger than 70 years and with a Karnofsky 
index>70. Ongoing studies are evaluating the possible value of combining these 
two treatments.