OVERVIEW

What Are Glial Cells in Glioma?

Glial cells, also known as neuroglia, are all non-neuronal cells widely distributed in the brain. They provide support and nourishment to neurons and also absorb and regulate certain active substances.

Glial cells retain the ability to divide and proliferate throughout life. They can phagocytize damaged or fragmented neurons, repair and fill gaps, and form scars. During the development of the cerebrum and cerebellum, glial cells act as guides, providing the initial structural framework for cellular organization.

Due to their potential for growth, glial cells also have the possibility of transforming into tumors.

What Is Glioma?

Glioma, also known as neuroglioma or gliocytoma, is the most common type of primary intracranial tumor. It is mainly classified into astrocytoma, glioblastoma, oligodendroglioma, medulloblastoma, ependymoma, and others.

Glioma arises from the cancerous transformation of glial cells in the brain and spinal cord, forming the most prevalent primary brain tumor. It impairs brain function, with early symptoms including localized seizures and later symptoms such as neurological deficits like paralysis. It poses a significant threat to human health.

In the treatment of glioma, drug therapy plays a crucial role. However, even with aggressive treatment, gliomas are highly prone to recurrence and have a poor prognosis. The median survival period is typically only 15–19 months, with a 5-year survival rate of just 5%. Globally, approximately 180,000–600,000 young and middle-aged individuals die from glioma each year, causing immense emotional distress and economic burdens to society and families.

Is Glioma Common?

It is the most common malignant tumor in the intracranial region, accounting for about 40%–50% of central nervous system tumors. It is characterized by "three highs and one low": high incidence, high recurrence rate, high mortality rate, and low cure rate.

SYMPTOMS

What are the symptoms and manifestations of patients with glioma?

Patients with glioma mainly exhibit nonspecific symptoms such as headaches, vomiting, and blurred vision. Some patients may experience epileptic seizures, commonly known as "convulsions" or "epilepsy." Others may present with paralysis in a single limb, emotional apathy, or mood changes, which are closely related to the tumor's location in the brain.

Is glioma malignant?

According to medical textbooks, glioma is classified as a malignant tumor. Malignancy here refers to rapid growth, a high likelihood of recurrence after resection, and a life-threatening nature regardless of treatment, making it a formidable brain tumor.

Do glioma patients experience seizures? How is it treated?

Glioma patients often suffer from epilepsy, particularly those with oligodendroglioma. For many low-grade glioma patients, epilepsy is the primary symptom.

Therefore, postoperative use of antiepileptic drugs is recommended for patients with oligodendroglioma and other low-grade hemispheric gliomas, as well as those with a history of epilepsy. If no seizures occur within a year, the medication can be discontinued.

CAUSES

What are the common causes of glioma?

The exact cause of this disease remains unclear, but it may be related to tumor origin, genetic factors, biochemical environment, ionizing radiation, nitroso compounds, polluted air, unhealthy lifestyle habits, infections, and other factors.

What are the common high-risk groups for glioma? Is everyone at risk?

Since gliomas are primary brain tumors, everyone has a potential risk, though the likelihood is low. The annual incidence of glioma is approximately 5 per 100,000, with a higher prevalence in men than women. The incidence significantly increases in people over 65 years old.

Among malignant gliomas, anaplastic gliomas and glioblastomas are the most common. Glioblastomas account for about 50% of all gliomas, with median ages at diagnosis of 45 years for anaplastic gliomas and 64 years for glioblastomas.

Is glioma contagious?

No, it is not contagious.

DIAGNOSIS

Under what circumstances can glioma be self-diagnosed?

It is recommended to visit the neurosurgery or brain surgery department. Based on relevant examinations and clinical manifestations, a doctor will make a definitive diagnosis. Self-diagnosis is not possible.

What tests are needed when glioma is suspected?

The diagnosis of glioma is based on an analysis of its biological characteristics, age, gender, common locations, and clinical progression. On the basis of medical history and physical signs, auxiliary examinations such as cerebrospinal fluid tests, electroencephalography (EEG), radionuclide imaging, CT, and MRI are used.

Among these, MRI is more accurate than CT in diagnosing brain tumors, providing clearer images. It can detect tiny tumors that CT cannot reveal and identify the tumor's morphology and characteristics. The accuracy of localization is almost 100%, while the accuracy of qualitative diagnosis can exceed 90%.

What precautions should be taken for an MRI scan for glioma?

Before undergoing an MRI, ensure that no metal objects are implanted or carried in the body, such as pacemakers, post-fracture fixation steel plates, nails, screws, artificial prostheses or joints, or hearing aids.

However, some implanted "steel plates" may be permissible. The specific material must be confirmed, and advice from a doctor should be sought for individual cases.

TREATMENT

Can gliomas be cured?

Not necessarily.

Over the past 30 years, advancements have been made in neuroimaging and glioma treatment. For example, pilocytic astrocytomas can be cured after complete resection, but the prognosis for malignant gliomas remains poor.

The 1-year and 5-year survival rates for adult malignant gliomas are approximately 30% and 13%, respectively. Known prognostic factors include tumor histopathology, patient age, and overall health.

What are the treatment options for gliomas?

The primary treatment is surgical resection, supplemented by radiotherapy and chemotherapy for malignant gliomas.

What is the significance of surgery for gliomas?

Surgery can relieve clinical symptoms, prolong survival, and provide sufficient tissue samples for pathological diagnosis and molecular studies.

Due to the complexity of the brain's nervous system, surgeons aim to minimize damage to healthy tissue to preserve quality of life.

What is the significance of radiotherapy for gliomas?

Postoperative radiotherapy benefits survival in malignant gliomas. Studies show that recurrences often occur within 2 cm of the original tumor site.

Thus, even if imaging suggests complete resection, adjuvant radiotherapy is recommended to delay recurrence and extend survival.

What is the significance of chemotherapy for gliomas?

Chemotherapy helps eliminate residual tumor cells, improving progression-free and overall survival. Its role in treating malignant gliomas is increasingly recognized, especially with the development of new drugs.

Do gliomas recur?

Some do.

Only a small fraction of gliomas achieve true clinical cure. Most high-grade gliomas recur, and even low-grade gliomas have a 50% recurrence rate, often with higher malignancy upon relapse.

How can glioma recurrence be prevented or managed?

Regular follow-ups are essential. For low-grade gliomas, MRI every 3–6 months (annually after 5 years).

For high-grade gliomas, MRI 2–6 weeks post-radiotherapy, then every 2–3 months for 2–3 years, and every 3–6 months thereafter. Consult a specialist if recurrence is suspected.

Is reoperation possible for recurrent gliomas?

Surgery may be considered if:

• The patient can tolerate surgery, and the recurrence is localized and resectable;
• Even if complete resection is unachievable, surgery can relieve significant mass effect and intracranial pressure. Caution is needed if recurrence cannot be distinguished from treatment effects (e.g., radiation necrosis).

Is re-radiotherapy possible for recurrent gliomas?

• If no prior radiotherapy, conventional external beam radiation is recommended;
• If prior radiotherapy occurred over 2 years ago or recurrence is outside the original radiation field, re-radiotherapy (e.g., 3D conformal, IMRT, or radiosurgery) may be considered.

Is re-chemotherapy possible for recurrent gliomas?

Yes.

Chemotherapy targets tumor cell metabolism, allowing repeated use. If prior regimens fail, drugs with different mechanisms are preferred.

DIET & LIFESTYLE

What should glioma patients and their families pay attention to?

• Maintain a positive attitude and cooperate with the attending physician's treatment plan;
• Adhere to regular follow-ups, engage in moderate physical exercise and neurological rehabilitation training to improve quality of life;
• For bedridden patients or those with frequent epileptic seizures, learn basic care methods to avoid panic and accidental injuries. If symptoms are uncontrollable, call an ambulance for timely hospital treatment to prevent increased stress for patients and families.

Can glioma patients conceive after treatment?

Childbirth is not recommended within one year after radiotherapy or chemotherapy for glioma patients. If medication has been discontinued, pregnancy may be considered.

PREVENTION

Can glioma be prevented? How to prevent glioma?

There is currently no effective prevention method. Regular health checkups are recommended for early detection of abnormalities.