Grade 2 and 3 gliomas: when is radiotherapy needed?

Not all gliomas are the same

Grade 2 and 3 diffuse gliomas include several diseases, such as IDH-mutant astrocytoma and IDH-mutant, 1p/19q-codeleted oligodendroglioma. These findings, obtained from tumour analysis, help predict behaviour and guide treatment. Some grow slowly, but they are not necessarily benign.

Who may need radiotherapy after surgery?

After surgery, some patients can be followed with regular MRI scans for a time, while others are more likely to benefit from radiotherapy, sometimes combined with medicine. The decision depends on the molecular diagnosis, grade, residual tumour, symptoms, age and imaging changes. There is no single approach for every glioma.

Why discuss memory and other functions?

Both tumour location and treatment can affect thinking, speech, hearing, vision or movement. Radiotherapy planning aims to protect healthy structures, but possible late side effects matter, especially for people who may live many years after diagnosis.

What does follow-up involve?

Regular MRI scans help identify changes over time. Clinicians interpret true tumour growth, postoperative changes and treatment effects in the context of symptoms and previous images. The frequency of scans and treatment decisions are individualised.

Questions to ask

What is my complete molecular diagnosis? How much tumour remains after surgery? What is the likely benefit of radiotherapy now compared with surveillance? Will medicine be combined with treatment, and how will quality of life be protected?