Can patients with brain glioma be cured?

At present, the best treatment for patients with glioma is surgery, and surgical treatment of glioma is only the first step in treatment. In the later stages, patients must also receive radiotherapy, chemotherapy and other treatments. Therefore, patients with glioma should be cautious in choosing a treatment method.

1. Surgery

Surgery is often the first step in treating gliomas. Surgery can not only provide a final pathological diagnosis, but also quickly remove most of the tumor cells, relieve the patient's symptoms, and facilitate other treatments in the next step. For some low-grade gliomas, such as pilocytic astrocytomas, complete surgical resection can result in radical cure and long-term survival for patients. Current glioma surgery has entered an era of minimally invasive surgery, which is safer, less traumatic, and more complete in tumor removal than before. The use of microscopes in the removal of brain gliomas can more clearly identify the boundary between the tumor and brain tissue, as well as important surrounding structures such as nerves and blood vessels, thereby maximizing the removal of gliomas while being safe. The application of neuronavigation has brought the surgical resection of gliomas to a new level. Neuronavigation is similar to car navigation, which allows surgeons to be more precise and detailed in terms of incision design before surgery, identification of functional brain areas during surgery, and selection of surgical resection methods. The intraoperative magnetic resonance imaging that has emerged in recent years can further improve the completeness of surgical resection and reduce the occurrence of complications such as postoperative functional defects in patients. The use of intraoperative cortical stimulation electrodes can improve the identification of motor and language areas during surgery, thereby helping surgeons better protect important brain functions.

2. Radiotherapy

After surgical treatment, patients with high-grade gliomas often require further radiotherapy. For patients with low-grade gliomas, radiotherapy should also be considered if there are high-risk factors (such as tumor volume exceeding 6 cm, incomplete surgical resection, etc.). Radiotherapy includes local radiotherapy and stereotactic radiotherapy. Stereotactic radiotherapy is generally not used for gliomas that are discovered for the first time. Local radiotherapy can be divided into conformal intensity-modulated radiotherapy and three-dimensional shaping radiotherapy according to the different techniques used. For patients with recurrent gliomas, especially those with tumors in functional areas, stereotactic radiotherapy can sometimes be considered.

3. Chemotherapy

Chemotherapy and targeted therapy have gradually played an important role in the treatment of gliomas. For high-grade gliomas, the use of temozolomide can significantly prolong the patient's survival prognosis. Currently, temozolomide is the only chemotherapy drug with clear efficacy in the treatment of glioma. For patients with newly diagnosed high-grade gliomas, temozolomide should be taken alone for a period of time (6-12 cycles) after being used simultaneously with radiotherapy (concurrent chemoradiotherapy stage). Other chemotherapy drugs (such as nimustine) may have certain effects on the treatment of recurrent glioma. The newly emerging vascular targeted drug, acrivastin, has a clear therapeutic effect on recurrent high-grade gliomas and can significantly prolong patients' survival. A recent interim analysis of a large-scale phase III study showed that for patients with newly diagnosed high-grade gliomas, the combination of acrivastin with radiotherapy and temozolomide can significantly improve patients' progression-free survival and is expected to become one of the standard treatment options.