What other treatments are needed for glioma besides surgery?

  Glioma is the most common primary intracranial tumor, and more than 3/4 of them are high-grade gliomas. The literature reports that the average survival period from diagnosis to death without treatment is 17 weeks, and even after comprehensive treatment with surgery, the 1-year survival rate of glioblastoma is about 30% and the 5-year survival rate is less than 5%, which is second only to pancreatic cancer and lung cancer. Therefore, when people hear about brain tumors, they are often “afraid of tumors”.  Although the root cause of the poor prognosis of glioma is the lack of understanding of its pathogenesis and the lack of effective measures to control the infinite proliferation and apoptosis of tumor cells. However, 1. Glioma is regarded as a purely surgical disease with too much emphasis on surgical treatment, and it is mistakenly believed that glioma is not sensitive to chemotherapy and radiotherapy, especially after “satisfactory” resection of tumor, further adjuvant treatment such as radiotherapy + chemotherapy is not carried out timely and effectively; 2. 2. Due to the economic condition, patients and family members do not understand enough the meaning of post-operative radiotherapy and chemotherapy, or give up further treatment because the pathology report is malignant tumor after surgery, which is also an important reason for the poor survival quality and short survival time of this group of patients.  With the progress of modern medicine and standardized tumor treatment, the treatment effect of certain gliomas has been significantly improved, especially the average survival time of low-grade gliomas can be expected to reach 6-10 years. The US NCCN has formulated treatment norms for various tumors, and treatment according to the norms can significantly improve patients’ prognosis, prolong survival time and improve quality of life.  The standardized treatment of glioma refers to the combined treatment plan of neurosurgery, neuroradiotherapy, neurochemotherapy, neuropathology, neuroimaging, and other related disciplines, which mainly involves surgical resection plus adjuvant treatment such as radiotherapy and chemotherapy. For those who only do surgery without radiotherapy and chemotherapy; those who only do surgery and radiotherapy but not chemotherapy; those who only do surgery and chemotherapy but not radiotherapy are not standard treatment. Since there are no standardized guidelines for the treatment of glioma in China, the standardization of treatment for these patients is imminent.  Today’s neurosurgical techniques are able to achieve total resection of gliomas on imaging, but almost all patients still end up dying from local recurrence, spread and invasion. This is due to the biological characteristics of gliomas that have no envelope and no boundary growth, and even the most astute neurosurgeons cannot remove the tumor completely and cleanly. Therefore, clinical reliance on adjuvant treatments such as post-surgical radiotherapy and chemotherapy to kill residual tumor cells is also needed to improve outcomes. Therefore, to improve the prognosis of glioma patients, both doctors and patients need to cooperate actively to complete the overall standardized treatment plan of surgery + radiotherapy + chemotherapy.