Gliomas are a diverse group of tumours originating from glial cells in the brain and spinal cord, representing the most common primary brain tumour within the central nervous system. In the United States, there are 6 cases of gliomas diagnosed per 100,000 individuals annually, with an estimated 80,000 to 90,000 newly diagnosed primary brain tumours each year, approximately 25% being gliomas.
These tumours are classified into three main types based on their cell of origin: astrocytomas (from astrocytes), oligodendrogliomas (from oligodendrocytes), and ependymomas (from ependymal cells). The World Health Organisation grading system, now incorporating molecular markers such as IDH mutations and 1p/19q co-deletions, classifies gliomas from grade 1 (low-grade) to grade 4 (high-grade), with significant prognostic and therapeutic implications.
Common symptoms include headaches, seizures, nausea, vomiting, and focal neurological deficits. Diagnosis relies primarily on magnetic resonance imaging, with tissue sampling providing molecular characterisation essential for treatment planning.
Treatment approaches vary by grade and typically involve maximal safe surgical resection as the mainstay, followed by radiotherapy and chemotherapy for higher-grade tumours. The Stupp protocol (radiotherapy with concurrent temozolomide) remains the standard of care for high-grade gliomas. Low-grade gliomas generally have more favourable prognoses, whilst high-grade gliomas, particularly glioblastomas, have poorer outcomes due to their aggressive nature and high recurrence rates.
Recent advances in molecular profiling have led to more precise classification and targeted therapies, though the diffuse and infiltrative nature of high-grade gliomas continues to pose significant treatment challenges.
Source: StatPearls
