A pivotal clinical trial carried out in the early 1970s showed that among 303 GBM patients randomized to radiation or nonradiation therapy, those who received radiation had a median survival more than double those who did not. Subsequent clinical research has attempted to build on the backbone of surgery followed by radiation. On average, radiotherapy after surgery can reduce the tumor size to 107 cells. Whole-brain radiotherapy does not improve when compared to the more precise and targeted three-dimensional conformal radiotherapy. A total radiation dose of 60–65 Gy has been found to be optimal for treatment.GBM tumors are well known to contain zones of tissue exhibiting hypoxia, which are highly resistant to radiotherapy. Various approaches to chemotherapy radiosensitizers have been pursued, with limited success as of 2016. As of 2010, newer research approaches included preclinical and clinical investigations into the use of an oxygen diffusion-enhancing compound such as trans sodium crocetinate as radiosensitizers, and as of 2015 a clinical trial was underway. Boron neutron capture therapy has been tested as an alternative treatment for glioblastoma, but is not in common use. Chemotherapy
Most studies show no benefit from the addition of chemotherapy. However, a large clinical trial of 575 participants randomized to standard radiation versus radiation plus temozolomide chemotherapy showed that the group receiving temozolomide survived a median of 14.6 months as opposed to 12.1 months for the group receiving radiation alone. This treatment regimen is now standard for most cases of glioblastoma where the person is not enrolled in a clinical trial.
Quassia amara extract at 4% demonstrated to have clinical efficacy for rosacea. When compared to metronidazole 0.75% as usual care in a randomized, double-blinded clinical trial, Quassia amara extract at 4% demonstrated earlier onset of action, including improvement in telangiectasia, flushing, and papules. Quassia amara showed a sustained reduction of global assessment score at day 42 (reduced to 4.68 from baseline 7.65) compared to metronidazole at day 42 (reduced to 6.32 from baseline 7.2), p<0.001. Laser
Evidence for the use of laser and intense pulsed-light therapy in rosacea is poor. Outcomes
The highly visible nature of rosacea symptoms are often psychologically challenging for those affected. People with rosacea can experience issues with self-esteem, socializing, and changes to their thoughts, feelings, and coping mechanisms. Epidemiology
Rosaceae affects around 5% of people worldwide. Incidence varies by ethnicity, and is particularly prevalent in those with Celtic heritage. Men and women are equally like to develop rosacea. See also
Seborrheic dermatitis
Keratosis pilaris

References
External links

Rosacea at Curlie
Rosacea photo library at Dermnet
Questions and Answers about Rosacea, from the US National Institute of Arthritis and Musculoskeletal and Skin Diseases