Adjuvant radiation therapy for high-grade gliomas
- Helen A Shih, MD
Helen A Shih, MD
- Associate Professor of Radiation Oncology
- Harvard Medical School
- Attending Radiation Oncologist
- Massachusetts General Hospital
- Tracy Batchelor, MD, MPH
Tracy Batchelor, MD, MPH
- Giovanni Armenise Professor of Neurology
- Harvard Medical School
- Section Editors
- Jay S Loeffler, MD
Jay S Loeffler, MD
- Section Editor — Neurooncology
- Professor of Radiation Oncology
- Harvard Medical School
- Patrick Y Wen, MD
Patrick Y Wen, MD
- Section Editor — Neurooncology
- Professor of Neurology
- Harvard Medical School
High-grade gliomas are malignant brain tumors that include the most common malignant primary brain tumor in adults, glioblastoma, as well as anaplastic astrocytoma and anaplastic oligodendroglioma. The diffuse gliomas are further subdivided according to isocitrate dehydrogenase (IDH) mutation status and the presence or absence of codeletion of chromosomes 1p and 19q . (See "Classification and pathologic diagnosis of gliomas".)
Most high-grade gliomas are best managed with a combined modality approach, incorporating adjuvant postoperative radiation therapy (RT) and adjuvant chemotherapy following initial surgery. Postoperative RT is discussed in this topic.
Other patient management topics that are covered separately include:
●The diagnostic approach to patients with suspected brain tumors (see "Overview of the clinical features and diagnosis of brain tumors in adults")
●Initial surgical management of high-grade gliomas (see "Clinical manifestations and initial surgical approach to patients with high-grade gliomas")To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- SURGICAL RESECTION
- RADIATION THERAPY
- Survival benefit from RT
- Involved field radiation therapy
- 3D conformal RT
- Intensity-modulated RT
- Other techniques
- - Stereotactic radiosurgery
- - Interstitial brachytherapy
- - Heavy particle RT
- Radiation sensitizers
- Elderly patients
- ADJUVANT CHEMOTHERAPY
- ASSESSMENT OF RESPONSE AND PROGRESSION
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS