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1. Maximal safe surgical resection
The cornerstone of treatment. Gross total resection is pursued whenever feasible while preserving neurological function, reducing tumor burden, relieving symptoms, and providing tissue for definitive diagnosis.
2. Intraoperative neuronavigation and minimally invasive techniques
Neuronavigation, intraoperative MRI, and fluorescence-guided surgery improve delineation of tumor margins and enable safer, more complete resection.
3. Stereotactic biopsy
For deep-seated tumors or lesions in eloquent areas, stereotactic biopsy enables minimally invasive acquisition of tissue for histopathology and molecular classification.
4. Radiotherapy (external beam)
A standard adjuvant treatment after surgery for high-grade disease. Intensity-modulated radiotherapy precisely targets the tumor bed while sparing normal brain tissue.
5. Chemotherapy
Concurrent and adjuvant temozolomide is a first-line regimen; PCV may be used in selected low-grade or recurrent cases.
6. Tumor treating fields (TTFields)
Alternating electric fields worn for ≥18 hours daily to disrupt mitosis, and has been shown to prolong survival in newly diagnosed and recurrent glioblastoma.
7. Targeted therapy
BRAF V600E inhibitors can be effective in tumors with this alteration; bevacizumab can reduce edema and help control recurrent glioblastoma.
8. Immunotherapy
Immune checkpoint inhibitors, CAR-T therapy, and other approaches remain largely within clinical trials and may provide options for recurrent or refractory disease.
9. Laser interstitial thermal therapy (LITT)
Stereotactically placed laser fibers deliver thermal ablation of small deep recurrent lesions with MRI thermometry guidance.
10. Supportive and symptomatic care
Longitudinal management of cerebral edema, seizures, pain, nutrition, and rehabilitation to optimize quality of life.
11. Multidisciplinary collaborative model
An MDT team integrates expertise across specialties to develop individualized treatment sequencing and follow-up plans.
Jinshazhou Hospital of Guangzhou University of Chinese Medicine emphasizes that astrocytoma — especially high-grade disease — poses a serious threat to life and remains challenging to treat. The core principles are maximal safe resection and MDT-based multimodal therapy guided by molecular subtyping, with early accurate diagnosis as the prerequisite. Sequential integration of surgery, chemoradiotherapy, targeted agents, and TTFields, together with MDT-led longitudinal management, can delay progression, preserve function, and prolong high-quality survival. Patients are encouraged to remain engaged and adhere closely to care plans.
1. Maximal safe surgical resection
The cornerstone of treatment. Gross total resection is pursued whenever feasible while preserving neurological function, reducing tumor burden, relieving symptoms, and providing tissue for definitive diagnosis.
2. Intraoperative neuronavigation and minimally invasive techniques
Neuronavigation, intraoperative MRI, and fluorescence-guided surgery improve delineation of tumor margins and enable safer, more complete resection.
3. Stereotactic biopsy
For deep-seated tumors or lesions in eloquent areas, stereotactic biopsy enables minimally invasive acquisition of tissue for histopathology and molecular classification.
4. Radiotherapy (external beam)
A standard adjuvant treatment after surgery for high-grade disease. Intensity-modulated radiotherapy precisely targets the tumor bed while sparing normal brain tissue.
5. Chemotherapy
Concurrent and adjuvant temozolomide is a first-line regimen; PCV may be used in selected low-grade or recurrent cases.
6. Tumor treating fields (TTFields)
Alternating electric fields worn for ≥18 hours daily to disrupt mitosis, and has been shown to prolong survival in newly diagnosed and recurrent glioblastoma.
7. Targeted therapy
BRAF V600E inhibitors can be effective in tumors with this alteration; bevacizumab can reduce edema and help control recurrent glioblastoma.
8. Immunotherapy
Immune checkpoint inhibitors, CAR-T therapy, and other approaches remain largely within clinical trials and may provide options for recurrent or refractory disease.
9. Laser interstitial thermal therapy (LITT)
Stereotactically placed laser fibers deliver thermal ablation of small deep recurrent lesions with MRI thermometry guidance.
10. Supportive and symptomatic care
Longitudinal management of cerebral edema, seizures, pain, nutrition, and rehabilitation to optimize quality of life.
11. Multidisciplinary collaborative model
An MDT team integrates expertise across specialties to develop individualized treatment sequencing and follow-up plans.
Jinshazhou Hospital of Guangzhou University of Chinese Medicine emphasizes that astrocytoma — especially high-grade disease — poses a serious threat to life and remains challenging to treat. The core principles are maximal safe resection and MDT-based multimodal therapy guided by molecular subtyping, with early accurate diagnosis as the prerequisite. Sequential integration of surgery, chemoradiotherapy, targeted agents, and TTFields, together with MDT-led longitudinal management, can delay progression, preserve function, and prolong high-quality survival. Patients are encouraged to remain engaged and adhere closely to care plans.