New Delhi: For decades, a diagnosis of high-grade glioma — one of the most aggressive forms of brain cancer — was associated with poor survival and limited treatment options. But advances in molecular diagnostics, precision surgery, targeted therapies and modern radiation techniques are steadily changing that outlook.According to neuro-oncology experts, median survival among many high-grade glioma patients has improved from about 9-12 months to 14-18 months, while some centres are reporting nearly 40% two-year survival among Grade-III and Grade-IV glioma patients. A small subset of patients are now surviving beyond a decade.Dr Shyam Agarwal, senior consultant, medical oncology, Sir Ganga Ram Hospital, said the perception that a brain tumour diagnosis is invariably fatal is outdated. “Once people hear the word tumour in the brain, many feel nothing can be done and life has come to an end. But brain tumours can be benign or malignant, and even among malignant tumours there are different grades. Today, we have multiple treatment options, including surgery, radiation and targeted drugs, which can control disease for long periods and, in selected cases, even offer a cure,” he said.Experts say improvements in surgery, radiation therapy and molecular diagnostics are among the key reasons behind better outcomes.Dr Amitabh Gupta, director, neurosurgery, PSRI Hospital, said technologies such as neuronavigation, operating microscopes and fluorescent markers now allow surgeons to distinguish tumour tissue more accurately during surgery. “These tools help maximise safe tumour removal while preserving healthy nervous tissue. Combined with stereotactic radiosurgery and molecularly guided chemotherapy, they are improving tumour control, survival and quality of life. Even in recurrent tumours, repeat surgery along with chemo-radiosurgery is yielding encouraging results,” he said.Dr Tejinder Kataria, chairperson, radiation oncology, Medanta, said advances in radiation delivery have significantly improved outcomes for patients with high-grade gliomas. “We are now able to deliver highly precise tumoricidal doses while protecting normal tissue. Median survival has improved from around 9-12 months to 14-18 months. Nearly 40% of our Grade-III and -IV glioma patients survive beyond two years, and some have lived for over a decade,” she said.Dr Agarwal said molecular testing has become central to treatment planning. “Comprehensive genomic profiling is increasingly becoming essential. If an IDH1 mutation is identified, patients may benefit from targeted therapies such as Vorasidenib. Gene sequencing is helping doctors identify precision-medicine options that were not available a few years ago,” he said.“Markers such as IDH mutations and MGMT status, along with comprehensive genomic sequencing, are helping identify patients who may benefit from targeted therapies. Precision diagnostics and multidisciplinary care are translating into longer survival and better quality of life,” said Dr R Ranga Rao, chairman, medical oncology, Paras Health.Despite these advances, specialists say delayed diagnosis remains a major challenge.Dr Agarwal said symptoms such as persistent headaches are often treated as stress, migraine or other common conditions, delaying diagnosis and treatment. Specialists are also reporting a growing number of younger adults presenting with gliomas and astrocytomas. Brain tumours account for around 2% of all cancers diagnosed in India, while gliomas and astrocytomas occur at an estimated rate of five to 10 cases per 1 lakh population annually.Researchers believe the future lies in precision oncology and next-generation immunotherapies.Dr Pranav Sopory, medical and patient affairs director, Servier India, said treatment is moving away from a “one-size-fits-all” approach. “Innovations such as targeted therapies, immunotherapy and CAR-T cell research offer hope for better outcomes in the coming years,” he said.
