Modern Treatments for Gliomas Improve Outcome

Abstract

: Glioma is the most common type of tumor in the central nervous system (CNS). Diagnosis is made by history, physical examination, radiology, histology and molecular profiles. Magnetic resonance imaging is a standard workup for all CNS tumors. Multidisciplinary team management is strongly recommended. The management of low grade gliomas is still controversial with regards to early surgery, radiotherapy, chemotherapy, versus watchful waiting. Patients with suspected high grade gliomas should undergo assessment by neurosurgeons for consideration of maximum safe resection to achieve optimal tumor debulking, and to provide adequate tissue for histologic and molecular diagnosis. Post-operative radiotherapy and/or chemotherapy are given depending on disease grade and patient performance. Most consider glioblastoma incurable. Treatment approaches in the elderly, pediatric population and recurrent gliomas are discussed with latest updates in the literature. Treatment considerations include performance status, neurocognitive functioning, and co-morbidities. Important genetic mutations, clinical trials and guidelines are summarized in this review.