Comprehensive treatment of glioma

  Glioma occurs in the neuroectoderm and is the most common neuroepithelial tumor in the skull, accounting for about 40-45% of intracranial tumors, and is the most common malignant tumor in the skull, for which there is no satisfactory treatment.  The pathological grading of common glioma is relatively large for the prognostic image of glioma. Currently, common grading in China: grade I (hairy cell astrocytoma, etc.), no obvious histological malignant features; grade II (astrocytoma, etc.) shows atypical nuclei; grade III (mesenchymal astrocytoma, etc.), atypical nuclei and visible mitosis; grade IV (glioblastoma, etc.), visible endothelial hyperplasia and necrosis. The malignancy of the tumor increases with the tumor grade, and the survival decreases with the tumor grade.  The main treatments for glioma include surgery, radiotherapy, chemotherapy, immunotherapy and gene therapy.  For all glioma patients, surgery should be considered as long as there is no clear contraindication to surgery, especially for low-grade glioma, surgery can significantly prolong the survival period and improve the quality of survival.  For glioma, radiation therapy is an important part of glioma treatment. For low-grade glioma, such as grade I, postoperative radiotherapy is not recommended (except for postoperative review with signs of recurrence, radiotherapy can be considered); for grade II or above glioma, radiotherapy is recommended routinely. At present, there are more radiotherapy devices, such as gamma knife, X-knife, linear gas pedal, etc. According to different conditions, suitable radiotherapy methods are selected.  For chemotherapy of glioma, chemotherapeutic drugs are mainly selected according to the sensitivity of tumor cells in vivo, or nimostatin and temozolomide can be used, which are often carried out simultaneously with radiation therapy.  Immunotherapy for tumors is an adjuvant after surgery, radiotherapy and chemotherapy, mainly including TIL (tumor-infiltrating lymphocytes) and LAK (cytokine-activated killer cells).  Gene therapy for glioma is currently an important research direction for the comprehensive treatment of glioma.  In conclusion, the comprehensive treatment of glioblastoma is an important treatment for glioma, which can prolong the survival period and improve the quality of patients’ survival.