1. In newly diagnosed highly malignant gliomas (including glioblastoma and mesenchymal glioma), maximum surgical resection is the first step of treatment while preserving neurological function. Although total resection is the most desirable outcome, partial resection or stereotactic biopsy is also feasible considering the location and size of the tumor. 2, For newly diagnosed glioblastoma, we recommend postoperative radiation therapy and administration of concurrent and subsequent temozolomide chemotherapy, rather than systemic nitrosoureas or carmustine multimer patches. 3, A multicenter, randomized, preliminary clinical trial showed that Novottf, an alternating low-intensity electromagnetic field stimulation device with temozolomide chemotherapy, prolonged patients’ progression-free and overall median survival. 4. For newly diagnosed glioblastoma, we do not recommend the use of bevacizumab in combination with standard radiotherapy and temozolomide. The reason for this is the lack of evidence for both the benefits and the risks associated with the use of bevacizumab in the initial phase. 5. For most newly diagnosed mesenchymal astrocytomas, we recommend radiation therapy followed by resection or biopsy and simultaneous and subsequent chemotherapy with temozolomide. The specific regimen is the same as the postoperative radiotherapy regimen for glioblastoma. Oligodendrogliomas (e.g., oligodendrogliomas and oligodendrocytomas) differ in important ways from other glial cell tumors. Many of these tumors contain a combined deletion of the short arm of chromosome 1 and the long arm of chromosome 19, and this presence results in a tumor that is not only particularly sensitive to chemotherapy, but also has a long natural history regardless of the treatment administered. 7. In any case, tumor specimens should be monitored for 1p19q and also examined for mutations in MGMT and IDH. 8. For newly diagnosed mesenchymal oligodendroglioma or oligodendrocytoma, we recommend surgical resection to the maximum extent possible while preserving neurological function. Although total resection is the most desirable outcome, partial resection or stereotaxy is also required given the location and size of the tumor. 9. For those patients who contain a simultaneous deletion of 1p/19q, we recommend to give radiotherapy regimen. It is inconclusive whether chemotherapy should be given before or after radiotherapy. Although the PCV (methylbenzylhydrazine, lomustine, vincristine) regimen was considered effective in two phase III clinical up trials, temozolomide is still listed as the first choice because of its ease of use and good tolerability. 10. For those patients without 1p/19q double deletion, we recommend administration of postoperative radiotherapy. Chemotherapy is delayed until the onset of lesion progression. Combination radiotherapy regimens can be used for specific patients, such as patients with MGMT methylated tumors. 11. Patients with oligodendroglial tumors need to be followed up with imaging after treatment. For mesenchymal glioma, MRI scans are needed every 2-6 weeks after radiotherapy, followed by MRI every 2-4 months and then stretched out again later. For those with low-grade malignant gliomas, MRI should be performed every 3-6 months for up to five years after surgery. 12. In elderly patients with malignant gliomas, careful assessment of the patient’s overall clinical status and coexisting disease is important, and at this time, an extensive physical and psychological evaluation is more useful. 13. For elderly patients with malignant gliomas, we recommend maximum surgical resection with preservation of neurological function, rather than biopsy as the initial treatment. However, considering the location and size of the tumor, the general status of the patient and the overall treatment goals, partial resection or stereotomy is also needed. (1) Patients close to 70 years of age, with good general status and no serious coexisting disease, we recommend giving radiotherapy in combination with chemotherapy rather than a single treatment modality. (2) Patients ≥70 years of age, generally in good condition, without serious coexisting disease, we recommend giving radiotherapy combination therapy rather than a single treatment modality. If the side effects of the treatment are contraindicated, one treatment option alone may be chosen. Elderly patients who are not suitable for combination therapy because of poor general status or significant coexisting disease may choose treatment based on MGMT methylation status: (3) For tumors with unmethylated MGMT, we choose short-term radiotherapy (40 Gy in 15 doses) rather than temozolomide alone (4) For patients with methylated MGMT, we recommend giving temozolomide rather than radiotherapy. 14. Glioblastoma usually recurs or progresses within the first year after diagnosis and initial treatment. For elderly patients who develop progression, bevacizumab is the most commonly used drug among elderly patients.