What are the treatment options for gliomas?

The treatment for a glioma depends on its grade. There are four grades of brain tumors; however, gliomas are most often referred to as "low grade" (grades I or II) or "high grade" (grades III or IV), based on the tumor’s growth potential and aggressiveness.

The best treatment for an individual patient takes into account the tumor location, potential symptoms, and potential benefits versus risks of the different treatment options (modalities).

Treatment for a glioma is customized to the individual patient and may include surgery, radiation therapy, chemotherapy or observation.

Surgery is the most common initial treatment for gliomas, and requires craniotomy (opening of the skull). It is sometimes performed with intraoperative MRI or intraoperative brain mapping if the tumor is near important areas of the brain.

A biopsy taken during surgery provides tissue samples to the pathologist, who will then be able to make an accurate diagnosis of the tumor's composition and characteristics so you can get the best treatment.

Surgery can also allow for the removal of tumor tissue to relieve pressure in the brain. This may be an urgent procedure.

Radiation therapy and chemotherapy usually follow surgery once the diagnosis or name of the tumor is determined. These treatments are called adjuvant treatments.

Radiation therapy is performed after surgery for some types of gliomas or for those in locations where surgery is not safe. Three types of radiation therapy are used to treat gliomas:

  • External beam radiation therapy
     
  • Stereotactic radiosurgery
     
  • Internal radiation

Chemotherapy, including wafers and targeted therapy, is recommended for some high-grade gliomas after surgery and radiation therapy.

  • Systemic, or standard, chemotherapy
     
  • Chemotherapy wafers
     
  • Targeted therapy

After treatment, brain scans (usually MRIs) may be performed to check for tumor growth. Sometimes the scans show areas that look like a recurrent tumor, but this is often dead tissue or changes in healthy tissue caused by radiation therapy, chemotherapy or both. Neurosurgeons and neuroradiologists will closely monitor this to determine whether the glioma has recurred. If so, your neurosurgeon may recommend another surgical procedure.

 

 

 

 


Sources:

  • Glioma is a broad category of brain and spinal cord tumors that come from glial cells brain cells that support nerve cells. “Brain Cancer and Gliomas.” WebMD, WebMD, www.webmd.com/cancer/brain-cancer/malignant-gliomas#2.
  • “Glioma | American Brain Tumor Association | Learn More.” American Brain Tumor Association, www.abta.org/tumor_types/glioma/.
  • “Glioma.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 12 Apr. 2019, www.mayoclinic.org/diseases-conditions/glioma/symptoms-causes/syc-20350251.
  • “Gliomas.” Gliomas | Johns Hopkins Medicine, www.hopkinsmedicine.org/health/conditions-and-diseases/gliomas.
  • Hammas, Nawal, et al. “Astroblastoma - a Rare and Challenging Tumor: a Case Report and Review of the Literature.” Journal of Medical Case Reports, BioMed Central, 21 Apr. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC5910607/.

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