From the Guidelines
Yes, glioma is generally considered a malignant cancer. Gliomas are tumors that originate from glial cells in the brain or spinal cord and represent about 30% of all brain tumors. While gliomas vary in their degree of malignancy, most are classified as malignant because they grow invasively into surrounding brain tissue, making complete surgical removal difficult or impossible. Gliomas are graded on a scale from I to IV according to the World Health Organization classification, with higher grades indicating more aggressive behavior. Grade I and some Grade II gliomas may be considered low-grade or benign, but they can still progress to higher grades over time. The most aggressive form, glioblastoma (Grade IV), has a particularly poor prognosis with median survival of about 12-15 months even with standard treatment including surgery, radiation, and chemotherapy with temozolomide. Treatment approaches depend on the specific type, grade, location, and the patient's overall health status. The malignant nature of gliomas stems from their ability to infiltrate normal brain tissue, their resistance to conventional therapies, and their tendency to recur even after aggressive treatment.
Key Points
- Gliomas are classified as malignant due to their invasive growth into surrounding brain tissue
- Gliomas are graded from I to IV, with higher grades indicating more aggressive behavior
- Glioblastoma (Grade IV) has a poor prognosis with median survival of about 12-15 months
- Treatment approaches depend on the specific type, grade, location, and patient's overall health status
- The malignant nature of gliomas is due to their ability to infiltrate normal brain tissue, resistance to conventional therapies, and tendency to recur after aggressive treatment
According to the study by 1, surgery to the extent feasible is the first therapeutic intervention for all malignant glioma, and combined modality therapy with temozolomide and radiotherapy remains the standard of care for glioblastoma. Additionally, the study by 1 suggests that concomitant and adjuvant temozolomide chemotherapy has been demonstrated to significantly improve median and 2-year survival in a large randomized trial in glioblastoma.
Recommendations
- Surgery should be performed to the extent feasible for all malignant glioma
- Combined modality therapy with temozolomide and radiotherapy should be used for glioblastoma
- Concomitant and adjuvant temozolomide chemotherapy should be considered for glioblastoma patients
- Treatment approaches should be individualized based on the specific type, grade, location, and patient's overall health status.
From the Research
Definition and Classification of Glioma
- Glioma is a type of tumor that arises from the brain's glial cells, which provide support and protection for neurons.
- Gliomas can be classified into different types, including low-grade and high-grade gliomas, with high-grade gliomas being more aggressive and malignant.
Malignancy of Glioma
- High-grade gliomas, such as glioblastoma, are considered malignant cancers due to their rapid growth and tendency to invade surrounding brain tissue 2, 3, 4.
- The malignancy of glioma is characterized by its ability to progress and recur despite treatment, with a generally poor prognosis for patients with high-grade gliomas 5, 6.
Treatment and Prognosis of Glioma
- The standard treatment for high-grade gliomas typically involves a combination of surgery, radiation therapy, and chemotherapy, with the goal of removing as much of the tumor as possible and slowing its growth 2, 3, 4.
- Despite advances in treatment, the prognosis for patients with high-grade gliomas remains generally poor, with a median survival time of around 12-18 months 5, 6.
- Researchers are exploring new and innovative treatments for glioma, including gene therapy and immunotherapy, in an effort to improve patient outcomes and increase survival rates 5.