Diffuse gliomas (WHO grade 2,3 and 4) in adult patients are primary brain tumors which are characterized by progressive, infiltrative growth in the brain or spinal cord. Diffuse gliomas are incurable and patients’ life expectancy is shortened.
Outcome is worse for higher tumor grades. Low-grade gliomas (grade 2) are slow-growing and patients tend to have few symptoms at diagnosis, usually only epilepsy, but they will experience tumor progression over years. In contrast, glioblastomas (grade 4) are the most malignant – and most common – subtype, and most patients die within 2 years despite intensive treatment. Surgery, radiation therapy and chemotherapy are the currently available treatments.
In recent years, great advances were made in the understanding of diffuse gliomas because of molecular diagnostics, resulting in more precise classification of gliomas. Such classification has led to more tailored use of available treatments; also, many – molecularly based – experimental treatments are being tested in order to improve prognosis. Despite these efforts, virtually all patients still die from this disease after some time.
Next to a shortened life expectancy, patients also face symptoms which result from the tumor itself and the treatments: epilepsy, neurological deficits such as muscle weakness, speech problems (aphasia), cognitive deterioration, headache, nausea, loss of energy and behavioral problems are among the most common symptoms. Treatment of such symptoms is mostly supportive in nature, as the underlying neurological damage is currently irreparable.