Glioma is the most common primary intracranial tumor, accounting for about 31% of central nervous system tumors, and its incidence has been increasing year by year for the past 30 years. Malignant gliomas (WHO grade III and IV) account for about 77.5% of all gliomas and are the second leading cause of death among patients under 34 years of age, and have the third highest 5-year mortality rate among systemic tumors, after pancreatic cancer and lung cancer. The most important biological characteristic of glioma is that the tumor cells grow infiltratively, which is difficult to be excised completely and easy to recur after surgery. Surgery is the mainstay of glioma treatment, i.e. surgery to remove the tumor first, followed by adjuvant therapy such as radiotherapy, chemotherapy and biologic targeted therapy. However, the irregularity of the treatment plan and its operation has become a major obstacle to further improve the survival rate of glioma patients. To address this problem, in recent years, countries in Europe and the United States have developed evidence-based guidelines or recommendations for the treatment of glioma, and in 2009, the Tumor Specialized Group of the Neurosurgery Branch of the Chinese Medical Association made the first attempt to develop the “Chinese Consensus on the Diagnosis and Treatment of Malignant Glioma of the Central Nervous System” for clinical reference, in order to help standardize and improve the treatment of glioma. Standardized treatment refers to the treatment of patients in accordance with the treatment protocols, without violating the basic medical principles and the results of current recognized large-scale clinical trials. In China, the diagnostic level, treatment conditions and treatment concepts vary greatly among hospitals of different scales and regions for various reasons, and there are also different views on the selection of treatment plans, and the correct understanding and implementation of conventional treatment plans for glioma in some medical units need to be further improved, resulting in irregularities in the diagnosis and treatment of glioma nationwide, and the failure of advanced facilities and technologies to be universally applied. This not only affects the improvement of the prognosis of glioma patients, but also seriously hinders the improvement of the overall diagnosis and treatment level of glioma in China. The development of multi-technology integration of neurosurgery Surgery is still the main treatment tool in the comprehensive treatment of glioma, and it is also the main factor to determine the prognosis of glioma patients in the standardized treatment. The goal of surgical treatment of glioma has always been to remove the tumor tissue as completely as possible with maximum preservation of neurological function. Precise localization of the lesion and its relationship to the functional area during surgery has always been a prerequisite for a successful neurosurgical operation. In the last decade, advances in microsurgery, imaging techniques, and electrophysiological monitoring have made it possible for neurosurgeons to visualize and more accurately delineate anatomic and pathologic structures. The use of a combination of digital imaging techniques, such as functional magnetic resonance imaging (fMRI), diffusion tensor imaging (DTI), and magnetic resonance spectroscopy (MRS), has allowed neurosurgeons to optimize surgical strategies to achieve maximum safe resection of tumor tissue. Intraoperative MRI (iMRI) has been introduced in some large neurosurgical centers in China, which has positively contributed to the total resection of glioma in a safe manner. However, for most of the units, functional neuronavigation, intraoperative anesthesia arousal combined with intraoperative neurophysiological monitoring techniques (e.g., functional localization and subcortical stimulation of nerve conduction bundle localization) and intraoperative B-ultrasound imaging can also help neurosurgeons to identify the functional area to the maximum extent based on objective indices during surgical treatment, so as to obtain the maximum possible tumor resection with minimal tissue and neurological damage, which greatly improves the outcome of glioma surgery. Since the introduction of frameless neuronavigators in Beijing Tiantan Hospital and Shanghai Huashan Hospital in China, image-guided neurosurgery has become increasingly popular. Numerous studies have shown that frameless neuronavigators play a reliable role in determining tumor boundaries intraoperatively. The total resection rate of lesions under navigation is much higher than that of traditional surgical approaches, and permanent damage to functional brain areas can be effectively avoided. Modern advances in anesthetic drugs, monitoring, and surgical instruments have enabled the implementation of arousal anesthesia techniques, which provide a powerful adjunct to neurological function protection. At present, it is considered that intraoperative anesthesia arousal technique combined with electrophysiological monitoring technique is the gold standard for intraoperative localization of functional brain areas, especially language areas and motor areas, which has been implemented in several units in China. Arousal anesthesia allows patients to perform various intraoperative motor and cognitive tasks in a painless and awake state, without increasing patient pain or surgical risk, yet satisfying the need for intraoperative localization of functional area surgery, while resolving the drift of neural navigation caused by intraoperative brain tissue displacement. The application of synergistic electrophysiological monitoring technology, real-time intraoperative B-ultrasound image localization and neuronavigation technology can significantly improve the rate of surgical resection of functional area lesions and reduce the incidence of postoperative motor, sensory, language, cognitive and other important neurological deficits, thus prolonging patients’ postoperative survival time and improving their postoperative quality of life. Although the above-mentioned technologies are not yet fully popular in China, especially not much applied in primary hospitals, the new technologies will be gradually promoted and applied with the development of society and improvement of living standards. The construction of multi-technology integrated digital integrated neurosurgery platform is an important direction of glioma surgical treatment, which has great development space and potential. The importance of molecular pathology of tumor is becoming more and more obvious. It is very important to establish the prognosis and adjuvant therapy based on the molecular pathological characteristics of individual tumor. Glioma staging has been based on the Blue Book of Histological Staging of Tumors of the Central Nervous System issued by the World Health Organization (WHO) for many years, with cytomorphology as the main diagnostic basis. In recent years, the importance of glioma biomarkers in postoperative determination of tumors and adjuvant therapy selection is increasing. The Cancer Genome Atlas (TCGA) research program, jointly launched by the National Cancer Institute (NCI) and the National Human Genome Research Institute (NHGRI) in 2005, also identified glioblastoma (GBM) as one of the three representative tumors that need to be broken into first. Notable markers such as IDH1, EGFR, PTEN, p53, O6-methylguanine-DNA-methyltransferase (MGMT) and 1p/19q LOH have been proposed [5-7]. The detection of these biomarkers has been actively carried out in medical units in China, which is important to improve the individualized treatment and prognosis of patients with glioma. For example, DNA repair enzyme MGMT is detected by immunohistochemistry (some units use quantitative PCR for precise assessment of MGMT promoter methylation status), and negative protein expression or promoter methylation indicates that the tumor is sensitive to alkylating chemotherapeutic agents and vice versa; for oligodendroglioma-derived glioblastoma, chromosome 1p/19q heterozygous deletion is detected by fluorescence in situ hybridization (FISH). The 1p/19q heterozygous deletion suggests that patients with oligodendroglial tumors are sensitive to alkylating agent chemotherapy, and predicts a better prognosis for patients. The adjuvant therapy after surgery is valued. Gliomas have a tendency to recur, and recurrence is often accompanied by biological malignant progression from low-grade glioma (WHO grade II) to high-grade glioma (WHO grade III or IV). Therefore, timely and effective adjuvant therapy should be given to patients after satisfactory surgical resection of the tumor. Postoperative radiotherapy has been proven to be an effective adjuvant treatment for high-grade glioma in the 1970s, helping to reduce the local recurrence rate and increasing the median survival of patients with glioblastoma and mesenchymal astrocytoma to 9-12 months and 25-36 months, respectively. In recent years, radiation therapy has become a widely accepted adjuvant treatment modality for glioma, especially malignant glioma, in China, but there is no standardized reference for the outline of radiotherapy target area, selection of radiotherapy timing and optimization of radiotherapy technique, and the implementation varies greatly from place to place. Conventional external irradiation is the most widely used, with T2WI combined with Flair sequences for low-grade gliomas and target area mapping for high-grade gliomas based on the extent of intensification, with conventional irradiation doses of 1.8-2Gy/session, 5 times/week, for a total dose of 60Gy. The balance between tumor cell killing and normal tissue protection has not been well resolved. In recent years, 3D-CRT has become one of the mainstream precise radiotherapy techniques in China, which can improve the accuracy of radiotherapy planning by calculating the dose distribution based on the virtual image of the patient, evaluating and optimizing the irradiation effect in a timely manner, and theoretically has certain superiority in radiation dosimetry and radiobiology for tumor killing and normal organ protection. Theoretically, it is superior in radiation dosimetry and radiobiology for tumor killing and normal organ protection. Intensity-modulated radiotherapy (IMRT), stereotactic radiotherapy, and interstitial radiotherapy (BT) have also been performed in a few hospitals, but their efficacy is inconclusive. In recent years, the role of chemotherapy in the comprehensive treatment of glioma has been confirmed, but there are still many problems in clinical implementation. On the one hand, it is still common in China that patients give up treatment after learning that the tumor is malignant because they do not understand the treatment plan, or they cannot afford to continue chemotherapy after surgery due to economic conditions. On the other hand, most medical units in China do not have mature and complete neuro-oncology treatment teams, and lack of neuro-oncology physicians specializing in postoperative chemotherapy, and the disconnection between surgical treatment and postoperative adjuvant treatment is also one of the reasons for the irregularity of chemotherapy. At present, it is believed that chemotherapy should be routinely given to high-grade glioma, while low-grade glioma can be considered according to the degree of surgical resection and pathological type, and molecular pathology diagnosis is also important for the selection of chemotherapy regimen. Standardized chemotherapy should select lipid-soluble, small molecule drugs that can cross the blood-brain barrier, choose a mature chemotherapy regimen, and administer the drugs strictly according to the cycle of the dosing regimen. Temozolomide (TMZ) has been clinically proven to have good efficacy in glioma, and TMZ combined with synchronous radiotherapy followed by consolidation chemotherapy is the standard treatment for adult glioblastoma (GBM) [8-9], but other chemotherapeutic drugs such as ACNU, BCNU, CCNU and VM26 are still more commonly used in China due to the difference in patients’ ability to pay for the drugs. Foreign studies have demonstrated the efficacy of these drugs in the treatment of malignant glioma, but there is a lack of our own data with evidence-based medicine. In 2008, Shanghai Huashan Hospital initiated a multicenter prospective phase IV clinical study on the standard TMZ treatment protocol, which actively explored the establishment of a treatment strategy more suitable for our population. The first FDA-approved anti-angiogenic drug Avastin (bevacizumab) has also entered China as a second-line drug for glioma treatment, but its efficacy still lacks validation in large-scale randomized double-blind controlled studies in China. In addition to clinical treatment, the establishment of glioma follow-up databases and glioma tissue repositories has received increasing attention from research-based medical institutions. The integration of glioma clinical information and the biological information of the tumor itself is important for analyzing patient prognosis, evaluating treatment effects, discovering new glioma oncological features, and establishing individualized and comprehensive treatments. The first large scale multicenter clinical specimen bank for glioma in Chinese population has been established by several institutions in China, led by Capital Medical University, in accordance with the tumor specimen bank standard of M. D. Anderson Cancer Center (a major participant of TCGA program in the United States), which retains frozen tissue, paraffin tissue, plasma and blood cell specimens of patients with glioma. We have established a genomic database of gliomas in the Chinese population and performed bioinformatics and systems biology analyses of the data to identify key factors that are closely related to the malignant phenotype and clinical prognosis, which provides an important direction and reference basis for the continued exploration of the mechanisms of glioma development and standardized treatment protocols. The standardized treatment of glioma covers neurosurgery, neuro-oncology pathology, neuro-oncology radiotherapy, neuro-oncology imaging, neuro-oncology chemotherapy and neuro-oncology biotherapy, which is a multidisciplinary system treatment. Medical professionals should first standardize the treatment under the guidance of China’s glioma consensus, establish a practical individualized and comprehensive treatment plan through multidisciplinary cooperation according to China’s national conditions, and explore a more optimal treatment strategy from multicenter prospective clinical trials so that patients can get the most benefit.