Radiation therapy for malignant gliomas: Current options

Abstract

The role for adjuvant radiation therapy following surgical resection in the treatment of malignant gliomas is currently guided by the tumor histology and, increasingly, by the molecular genetic features. The standard of care for patients with glioblastoma is adjuvant radiation therapy with concomitant and subsequent temozolomide. For patients who are elderly and/or have a poor performance status, single modality approaches with radiation, including shorter-course regimens or temozolomide alone are reasonable. Anaplastic astrocytomas are treated similarly to glioblastoma with adjuvant chemoradiation. The role for radiation therapy for patients with anaplastic oligodendrogliomas is under active investigation given the chemosensitivity of these tumors. The optimal adjuvant therapy for low-grade gliomas is individualized and often dependent on a patient’s risk factors.