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
- 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 managed with a combined-modality approach, incorporating adjuvant postoperative radiation therapy (RT) and adjuvant chemotherapy following initial surgery. An overview of the use of RT in patients with high-grade glioma is presented here.
Other patient management topics that are covered separately include:
●Initial surgical management of high-grade gliomas (see "Clinical presentation, initial surgical approach, and prognosis of high-grade gliomas")
●Concurrent and adjuvant chemotherapy (see "Initial postoperative therapy for glioblastoma and anaplastic astrocytoma")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
- ADJUVANT RT
- Treatment target
- Dose selection
- Planning and delivery methods
- - 3D-conformal RT
- - Intensity-modulated RT
- Side effects
- Monitoring during use of concurrent temozolomide
- Older adults
- ASSESSMENT OF RESPONSE AND PROGRESSION
- Clinical and neuroimaging follow-up
- Patients with radiation-induced gliomas
- Role in recurrent glioblastoma
- OTHER TECHNIQUES
- Interstitial brachytherapy
- Heavy particle RT
- Radiation sensitizers
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS