Updated Recommendations Issued for Management of Grade 4 Diffuse Glioma
By Elana Gotkine HealthDay Reporter
TUESDAY, July 8, 2025 -- In a clinical practice guideline issued by the American Society for Radiation Oncology and published online June 25 in Practical Radiation Oncology, updated recommendations are presented for the management of World Health Organization (WHO) grade 4 adult-type diffuse glioma, focusing on radiation therapy (RT) and/or adjunctive therapies.
Debra Nana Yeboa, M.D., from the University of Texas MD Anderson Cancer Center in Houston, and colleagues developed recommendations for multidisciplinary management of WHO grade 4 adult-type diffuse glioma, focusing on diagnosis, initial treatment, reirradiation, and health disparities.
The authors note that concurrent RT with temozolomide followed by adjuvant temozolomide is recommended for eligible patients following maximum safe resection, molecular and pathologic diagnosis, and prognostic stratification of grade 4 adult-type diffuse glioma; incorporation of alternating electric field therapy is conditionally recommended. Hypofractionated RT with concurrent and adjuvant temozolomide is conditionally recommended for elderly patients. Following multidisciplinary, patient-centered discussion, supportive and palliative care is conditionally recommended for frail patients. Following pathologic or advanced imaging confirmation of WHO grade 4 diffuse glioma recurrence, appropriate reirradiation techniques, with or without additional systemic therapy, can be considered and are conditionally recommended. Patients with grade 4 adult-type diffuse glioma have health disparities; to improve outcomes and increase clinical trial enrollment for underserved populations, attention to these issues is necessary.
"Our goal was to equip clinicians with a clear, robust framework for shared decision-making with their patients, while also highlighting areas where research is needed to move the field forward," Yeboa said in a statement.
Several authors disclosed ties to the biopharmaceutical and medical technology industries.
Disclaimer: Statistical data in medical articles provide general trends and do not pertain to individuals. Individual factors can vary greatly. Always seek personalized medical advice for individual healthcare decisions.

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Posted July 2025
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