Glioma treatment is highly individualized, but it draws from a consistent set of tools. Understanding the menu helps you follow the plan your team designs around your specific tumor type, grade, molecular markers, location, age, and goals.
The main treatment categories are:
- Surgery. Often the first step. Goals are to remove as much tumor as is safely possible and to obtain tissue for diagnosis. For some low-grade tumors, surgery alone can be enough; for others, it's the foundation for further treatment.
- Radiation therapy. Uses targeted high-energy beams to damage tumor cells. It's a core treatment for many higher-grade gliomas and for some low-grade tumors that grow or carry higher-risk features.
- Chemotherapy. Drugs that kill or slow tumor cells. Temozolomide is the most commonly used, particularly for glioblastoma and many other gliomas.
- Targeted therapy. Newer drugs that attack specific molecular features. Vorasidenib targets IDH-mutant low-grade gliomas; BRAF-targeted drugs treat certain pediatric low-grade gliomas; dordaviprone targets H3 K27M diffuse midline glioma.
- Tumor Treating Fields. A wearable device using electrical fields, used for glioblastoma alongside chemotherapy.
- Clinical trials. Studies of new treatments, often a valuable option, especially for aggressive or recurrent tumors.
- Supportive (palliative) care. Manages symptoms, seizures, and quality of life — used alongside active treatment at every stage, not just at the end.
How are these combined? It depends entirely on the tumor. A grade 2 IDH-mutant glioma might be managed with surgery and surveillance, then radiation, chemo, or vorasidenib if it grows. A glioblastoma typically follows surgery with combined radiation and temozolomide, then more temozolomide, often with Tumor Treating Fields. A pediatric low-grade glioma may be treated with surgery and, if needed, chemo or targeted therapy, with radiation often avoided when possible.
The most important thing to know is that there is no single "glioma treatment." Your plan should be built by a multidisciplinary team and explained to you in terms of your specific situation — and you're entitled to understand the reasoning behind each recommendation.