neurosurgeryНейрохирургияRussian journal of neurosurgery1683-32952587-7569Издательский дом "МедИНК"10.17650/1683-3295-2021-23-1-124-134neurosurgery-1019Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWГлиомы высокой степени злокачественности: обзор литературы. Часть 1. Эпидемиология, классификация и подходы к комбинированному лечениюHigh-grade gliomas: a literature review. Part 1. Epidemiology, classification and approaches to combination treatmenthttps://orcid.org/0000-0003-1042-0837ГрецкихК. В.GretskikhK. V.

Константин Валерьевич Грецких

Россия, 129090 Москва, Большая Сухаревская пл., 3

Konstantin Valerievich Gretskikh

3 Bolshaya Sukharevskaya Sq., Moscow 129090, Russia

mail@rssklif.ruhttps://orcid.org/0000-0002-8415-5602ТокаревА. С.TokarevA. S.

Россия, 129090 Москва, Большая Сухаревская пл., 3

3 Bolshaya Sukharevskaya Sq., Moscow 129090, Russia

ГБУЗ «Научно-исследовательский институт скорой помощи им. Н. В. Склифосовского Департамента здравоохранения г. Москвы»РоссияN. F. Sklifosovsky Research Institute for Emergency Medicine, Moscow Healthcare DepartmentRussian Federation202104052021231124‑134Copyright © Грецких К.В., Токарев А.С., 20212021Грецких К.В., Токарев А.С.Gretskikh K.V., Tokarev A.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therjn.com/jour/article/view/1019

Злокачественные опухоли головного мозга считаются наиболее опасными не только из‑за плохого

прогноза, но и из‑за непосредственного ухудшения качества жизни и когнитивных функций. Предполагается, что число таких больных будет увеличиваться по мере роста продолжительности жизни населения.

Летальность пациентов со злокачественными глиомами остается самой высокой среди пациентов с онкологическими заболеваниями. Медиана их выживаемости не превышает 24,5 мес. Несмотря на то что молекулярная биология серьезно продвинулась в изучении данного типа опухолей, остается открытым вопрос об эффективном применении этих знаний в лечебном процессе.

В обзоре освещены передовые методы диагностики и преимущества мультидисциплинарного подхода к лечению. Особое внимание уделено радиохирургическому лечению глиом высокой степени злокачественности, способному увеличить продолжительность жизни пациентов и улучшить ее качество.

Обзор разделен на 2 части. В 1‑й части освещаются эпидемиология, клиника и диагностика глиом высокой степени злокачественности, а также комбинированный подход к их лечению.

Malignant brain tumors remain one of the most complex problem in modern oncology, being among the most dangerous types of cancer not only because of their poor prognosis, but also due to the immediate consequences for quality of life and cognitive functions. It is expected that the number of such patients will increase as the life expectancy of the population increases.

The mortality rate of patients with malignant gliomas remains the highest among all cancer patients. The median survival rate in this population does not exceed 24.5 months. Despite serious progress in the study of the molecular biology of this type of tumor, the question of effective application of this knowledge in the treatment process remains open.

The review highlights the most advanced diagnostic methods and analyzes the effectiveness of a multidisciplinary therapeutic strategy. Special attention is given to the search for new approaches to radiosurgical treatment of highgrade gliomas in order to increase the duration and improve the quality of life of patients.

The literature review is divided into 2 parts. Part 1 covers the epidemiology, clinic, and diagnosis of high-grade gliomas, as well as a combined approach to the treatment of the disease.

стереотаксическая радиохирургиягамма-ножглиома высокой степени злокачественностилучевая терапияхимиотерапияstereotactic radiosurgerygamma knifehigh-grade gliomaradiation therapychemotherapyReferencesThakkar J.P., Dolecek T.A., Horbinski C. et al. Epidemiologic and molecular prognostic review of glioblastoma. Cancer Epidemiol Biomarkers Prev 2014;23(10):1985–96. DOI: 10.1158/1055-9965.epi-14-0275.Thakkar J.P., Dolecek T.A., Horbinski C. et al. Epidemiologic and molecular prognostic review of glioblastoma. Cancer Epidemiol Biomarkers Prev 2014;23(10):1985–96. DOI: 10.1158/1055-9965.epi-14-0275.Бельский К.К., Гуров Д.Ю., Колесников А.Е. Заболеваемость злокачественными глиомами головного мозга в Волгоградской области. Российский онкологический журнал 2010;(4): 39–42.Belskiy K.K., Gurov D.Yu., Kolesnikov A.E. The incidence of malignant gliomas of the brain in the Volgograd region. Rossijskiy onkologicheskiy zhurnal = Russian Journal of Oncology 2010;(4):39–42. (In Russ.).Gilbert M.R., Wang M., Aldape K.D. et al. Dose-dense temozolomide for newly diagnosed glioblastoma: a randomized phase III clinical trial. J Clin Oncol 2013;31(32):4085–91. DOI: 10.1200/jco.2013.49.6968Gilbert M.R., Wang M., Aldape K.D. et al. Dose-dense temozolomide for newly diagnosed glioblastoma: a randomized phase III clinical trial. J Clin Oncol 2013;31(32):4085–91. DOI: 10.1200/jco.2013.49.6968Ostrom Q.T., Gittleman H., Farah P. et al. CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2006– 2010. Neuro Oncol 2013;15 Suppl 2:ii1–56. DOI: 10.1093/neuonc/not151.Ostrom Q.T., Gittleman H., Farah P. et al. CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2006– 2010. Neuro Oncol 2013;15 Suppl 2:ii1–56. DOI: 10.1093/neuonc/not151.Malignant Brain Tumors. Ed. by J. Moliterno Gunel, J.M. Piepmeier, J.M. Baehring. New York: Springer, 2017. DOI: 10.1007/978-3-319-49864-5.Malignant Brain Tumors. Ed. by J. Moliterno Gunel, J.M. Piepmeier, J.M. Baehring. New York: Springer, 2017. DOI: 10.1007/978-3-319-49864-5.Chen J., McKay R.M., Parada L.F. Malignant glioma: lessons from genomics, mouse models, and stem cells. Cell 2012;149(1):36–47. DOI: 10.1016/j.cell.2012.03.009.Chen J., McKay R.M., Parada L.F. Malignant glioma: lessons from genomics, mouse models, and stem cells. Cell 2012;149(1):36–47. DOI: 10.1016/j.cell.2012.03.009.Chamberlain M.C. The paradoxical effect of bevacizumab in the therapy of malignant gliomas. Neurology 2011;77(8):803–4. DOI: 10.1212/wnl.0b013e3182247068.Chamberlain M.C. The paradoxical effect of bevacizumab in the therapy of malignant gliomas. Neurology 2011;77(8):803–4. DOI: 10.1212/wnl.0b013e3182247068.Cheon Y.J., Jung T.Y., Jung S. et al. Efficacy of Gamma Knife radiosurgery for recurrent high-grade gliomas with limited tumor volume. J Korean Neurosurg Soc 2018;61(4):516–24. DOI: 10.3340/jkns.2017.0259.Cheon Y.J., Jung T.Y., Jung S. et al. Efficacy of Gamma Knife radiosurgery for recurrent high-grade gliomas with limited tumor volume. J Korean Neurosurg Soc 2018;61(4):516–24. DOI: 10.3340/jkns.2017.0259.Oppenlander M.E., Wolf A.B., Snyder L.A. et al. An extent of resection threshold for recurrent glioblastoma and its risk for neurological morbidity. J Neurosurg 2014;120(4):846–53. DOI: 10.3171/2013.12.jns13184.Oppenlander M.E., Wolf A.B., Snyder L.A. et al. An extent of resection threshold for recurrent glioblastoma and its risk for neurological morbidity. J Neurosurg 2014;120(4):846–53. DOI: 10.3171/2013.12.jns13184.Hong B., Wiese B., Bremer M. et al. Multiple microsurgical resections for repeated recurrence of glioblastoma multiforme. Am J Clin Oncol 2013;36(3):261–8. DOI: 10.1097/COC.0b013e3182467bb1.Hong B., Wiese B., Bremer M. et al. Multiple microsurgical resections for repeated recurrence of glioblastoma multiforme. Am J Clin Oncol 2013;36(3):261–8. DOI: 10.1097/COC.0b013e3182467bb1.Park J.K., Hodges T., Arko L. et al. Scale to predict survival after surgery for recurrent glioblastoma multiforme. J Clin Oncol 2010;28(24):3838–43. DOI: 10.1200/JCO.2010.30.0582.Park J.K., Hodges T., Arko L. et al. Scale to predict survival after surgery for recurrent glioblastoma multiforme. J Clin Oncol 2010;28(24):3838–43. DOI: 10.1200/JCO.2010.30.0582.Mazor T., Pankov A., Johnson B.E. et al. DNA methylation and somatic mutations converge on the cell cycle and define similar evolutionary histories in brain tumors. Cancer Cell 2015;28(3):307–17. DOI: 10.1016/j.ccell.2015.07.012.Mazor T., Pankov A., Johnson B.E. et al. DNA methylation and somatic mutations converge on the cell cycle and define similar evolutionary histories in brain tumors. Cancer Cell 2015;28(3):307–17. DOI: 10.1016/j.ccell.2015.07.012.Zikou A., Sioka C., Alexiou G.A. et al. Radiation necrosis, pseudoprogression, pseudoresponse, and tumor recurrence: imaging challenges for the evaluation of treated gliomas. Contrast Media Mol Imaging 2018;2018:6828396. DOI: 10.1155/2018/6828396.Zikou A., Sioka C., Alexiou G.A. et al. Radiation necrosis, pseudoprogression, pseudoresponse, and tumor recurrence: imaging challenges for the evaluation of treated gliomas. Contrast Media Mol Imaging 2018;2018:6828396. DOI: 10.1155/2018/6828396.Omuro A., DeAngelis L.M. Glioblastoma and other malignant gliomas: a clinical review. JAMA 2013;310(17):1842–50. DOI: 10.1001/jama.2013.280319.Omuro A., DeAngelis L.M. Glioblastoma and other malignant gliomas: a clinical review. JAMA 2013;310(17):1842–50. DOI: 10.1001/jama.2013.280319.Злокачественные новообразования в России в 2017 году (заболеваемость и смертность). Под ред. А.Д. Каприна, В.В. Старинского, Г.В. Петровой. М.: МНИОИ им. П.А. Герцена, 2018. 250 с.Malignant tumors in Russia in 2017 (morbidity and mortality). Ed by A.D. Kaprin, V.V. Starinsky, G.V. Petrova. Moscow: MNIOI im. P.A. Gertzena, 2018. 250 p. (In Russ.).Трашков А.П., Спирин А.Л., Цыган Н.В. и др. Глиальные опухоли головного мозга: общие принципы диагностики и лечения. Педиатр 2015;6(4):75–84. DOI: 10.17816/PED6475-84.Тrashkov A.P., Spirin A.L., Tsygan N.V. et al. Cerebral glial tumors: general principles of diagnostics and treatment. Pediatr = Pediatrician 2015;6(4):75–84. (In Russ.). DOI: 10.17816/PED6475-84.Дяченко А.А., Субботина А.В., Измай- лов Т.Р. и др. Первичные злокачественные новообразования центральной нервной системы в Архангельской области: структура и динамика эпидемиологических показателей в 2000–2011 гг. Вестник Российского научного центра рентгенорадиологии 2013;(13-1):12.Dyachenko A.A., Subbotina A.V., Izmajlov T.R. et al. Primary malignant tumors of the central nervous system in the Arkhangelsk Region, Russia: structure and dynamics of epidemiological indicators in 2000–2011. Vestnik Rossiyskogo nauchnogo tsentra rentgenoradiologii = Vestnik of the Russian Scientific Center of Roentgenoradiology 2013;(13-1):12. (In Russ.).Hanif F., Muzaffar K., Perveen K. et al. Glioblastoma multiforme: a review of its epidemiology and pathogenesis through clinical presentation and treatment. Asian Pac J Cancer Prev 2017;18(1):3–9. DOI: 10.22034/APJCP.2017.18.1.3.Hanif F., Muzaffar K., Perveen K. et al. Glioblastoma multiforme: a review of its epidemiology and pathogenesis through clinical presentation and treatment. Asian Pac J Cancer Prev 2017;18(1):3–9. DOI: 10.22034/APJCP.2017.18.1.3.Измайлов Т.Р., Паньшин Г.А., Даценко П.В. Выбор режима фракционирования при лечении глиом высокой степени злокачественности (часть 1): возраст и степень злокачественности. Сибирский онкологический журнал. 2012;(2):11–7.Izmaylov T.R., Panshin G.A., Datsenko P.V. Choice of fractionation regimen for treatment of high-grade gliomas (part 1): age and tumor grade. Sibirskiy onkologicheskiy zhurnal = Siberian Journal of Oncology 2012;(2):11–7. (In Russ.).Kamiya-Matsuoka C., Gilbert M.R. Treating recurrent glioblastoma: an update. CNS Oncol 2015;4(2):91–104. DOI: 10.2217/cns.14.5.Kamiya-Matsuoka C., Gilbert M.R. Treating recurrent glioblastoma: an update. CNS Oncol 2015;4(2):91–104. DOI: 10.2217/cns.14.5.Абсалямова О.В., Алешин В.А., Аникеева О.Ю. и др. Клинические рекомендации по диагностике и лечению больных с первичными опухолями головного мозга. М., 2014. 60 c.Absalyamova O.V., Aleshin V.A., Anikeeva O.Yu. et al. Clinical recommendations for the diagnosis and treatment of patients with primary brain tumors. Moscow, 2014. 60 p. (In Russ.).Rice T., Lachance D.H., Molinaro A.M. et al. Understanding inherited genetic risk of adult glioma – a review. Neurooncol Pract 2016;3(1):10–6. DOI: 10.1093/nop/npv026.Rice T., Lachance D.H., Molinaro A.M. et al. Understanding inherited genetic risk of adult glioma – a review. Neurooncol Pract 2016;3(1):10–6. DOI: 10.1093/nop/npv026.Baumgarten P., Quick-Weller J., Gessler F. et al. Pre- and early postoperative GFAP serum levels in glioma and brain metastases. J Neurooncol 2018;139(3):541–6. DOI: 10.1007/s11060-018-2898-1.Baumgarten P., Quick-Weller J., Gessler F. et al. Pre- and early postoperative GFAP serum levels in glioma and brain metastases. J Neurooncol 2018;139(3):541–6. DOI: 10.1007/s11060-018-2898-1.Van Bodegraven E.J., van Asperen J.V., Robe P. A.J., Hol E.M. Importance of GFAP isoform-specific analyses in astrocytoma. Glia 2019;67(8):1417–33. DOI: 10.1002/glia.23594.Van Bodegraven E.J., van Asperen J.V., Robe P. A.J., Hol E.M. Importance of GFAP isoform-specific analyses in astrocytoma. Glia 2019;67(8):1417–33. DOI: 10.1002/glia.23594.Cloughesy T.F., Cavenee W.K., Mischel P.S. Glioblastoma: from molecular pathology to targeted treatment. Annu Rev Pathol 2014;9:1–25. DOI: 10.1146/ annurev-pathol-011110-130324.Cloughesy T.F., Cavenee W.K., Mischel P.S. Glioblastoma: from molecular pathology to targeted treatment. Annu Rev Pathol 2014;9:1–25. DOI: 10.1146/ annurev-pathol-011110-130324.Agnihotri S., Burrell K.E., Wolf A. et al. Glioblastoma, a brief review of history, molecular genetics, animal models and novel therapeutic strategies. Arch Immunol Ther Exp (Warsz) 2013;61(1):25–41. DOI: 10.1007/s00005-012-0203-0.Agnihotri S., Burrell K.E., Wolf A. et al. Glioblastoma, a brief review of history, molecular genetics, animal models and novel therapeutic strategies. Arch Immunol Ther Exp (Warsz) 2013;61(1):25–41. DOI: 10.1007/s00005-012-0203-0.Ohgaki H., Kleihues P. The definition of primary and secondary glioblastoma. Clin Cancer Res 2013;19(4):764–72. DOI: 10.1158/1078-0432.CCR-12-3002.Ohgaki H., Kleihues P. The definition of primary and secondary glioblastoma. Clin Cancer Res 2013;19(4):764–72. DOI: 10.1158/1078-0432.CCR-12-3002.Malta T.M., de Souza C.F., Sabedot T.S. et al. Glioma CpG island methylator phenotype (G-CIMP): biological and clinical implications. Neuro Oncol 2018;20(5):608–20. DOI: 10.1093/neuonc/nox183.Malta T.M., de Souza C.F., Sabedot T.S. et al. Glioma CpG island methylator phenotype (G-CIMP): biological and clinical implications. Neuro Oncol 2018;20(5):608–20. DOI: 10.1093/neuonc/nox183.Hervey-Jumper S.L., Berger M.S. Maximizing safe resection of low- and high-grade glioma. J Neurooncol 2016;130(2):269–82. DOI: 10.1007/s11060-016-2110-4.Hervey-Jumper S.L., Berger M.S. Maximizing safe resection of low- and high-grade glioma. J Neurooncol 2016;130(2):269–82. DOI: 10.1007/s11060-016-2110-4.Chen W.J., He D.S., Tang R.X. et al. Ki-67 is a valuable prognostic factor in gliomas: evidence from a systematic review and meta-analysis. Asian Pac J Cancer Prev 2015;16(2):411–20. DOI: 10.7314/apjcp.2015.16.2.411.Chen W.J., He D.S., Tang R.X. et al. Ki-67 is a valuable prognostic factor in gliomas: evidence from a systematic review and meta-analysis. Asian Pac J Cancer Prev 2015;16(2):411–20. DOI: 10.7314/apjcp.2015.16.2.411.Yan H., Parsons D.W., Jin G. et al. IDH1 and IDH2 mutations in gliomas. N Engl J Med 2009;360(8):765–73. DOI: 10.1056/NEJMoa0808710.Yan H., Parsons D.W., Jin G. et al. IDH1 and IDH2 mutations in gliomas. N Engl J Med 2009;360(8):765–73. DOI: 10.1056/NEJMoa0808710.Snyder L.A., Wolf A.B., Oppenlander M.E. et al. The impact of extent of resection on malignant transformation of pure oligodendrogliomas. J Neurosurg 2014;120(2):309–14. DOI: 10.3171/2013.10.JNS13368.Snyder L.A., Wolf A.B., Oppenlander M.E. et al. The impact of extent of resection on malignant transformation of pure oligodendrogliomas. J Neurosurg 2014;120(2):309–14. DOI: 10.3171/2013.10.JNS13368.Ferguson S., Lesniak M.S. Percival Bailey and the classification of brain tumors. Neurosurg Focus 2005;18(4):e7. DOI: 10.3171/foc.2005.18.4.8.Ferguson S., Lesniak M.S. Percival Bailey and the classification of brain tumors. Neurosurg Focus 2005;18(4):e7. DOI: 10.3171/foc.2005.18.4.8.Huse J.T., Diamond E.L., Wang L., Rosenblum M.K. Mixed glioma with molecular features of composite oligodendroglioma and astrocytoma: a true “oligoastrocytoma”? Acta Neuropathol 2015;129(1):151–3. DOI: 10.1007/s00401-014-1359-y.Huse J.T., Diamond E.L., Wang L., Rosenblum M.K. Mixed glioma with molecular features of composite oligodendroglioma and astrocytoma: a true “oligoastrocytoma”? Acta Neuropathol 2015;129(1):151–3. DOI: 10.1007/s00401-014-1359-y.Elaimy A.L., Mackay A.R., Lamoreaux W.T. et al. Clinical outcomes of Gamma Knife radiosurgery in the salvage treatment of patients with recurrent high-grade glioma. World Neurosurg 2013;80(6):872–8. DOI: 10.1016/j.wneu.2013.02.030.Elaimy A.L., Mackay A.R., Lamoreaux W.T. et al. Clinical outcomes of Gamma Knife radiosurgery in the salvage treatment of patients with recurrent high-grade glioma. World Neurosurg 2013;80(6):872–8. DOI: 10.1016/j.wneu.2013.02.030.Nayak L., Reardon D.A. High-grade gliomas. Continuum (Minneap Minn) 2017;23(6, Neuro-oncology):1548–63. DOI: 10.1212/con.0000000000000554.Nayak L., Reardon D.A. High-grade gliomas. Continuum (Minneap Minn) 2017;23(6, Neuro-oncology):1548–63. DOI: 10.1212/con.0000000000000554.Stupp R., Roila F. Malignant glioma: ESMO clinical recommendations for diagnosis, treatment and follow-up. Ann Oncol 2009;20 Suppl 4:126–8. DOI: 10.1093/annonc/mdp151.Stupp R., Roila F. Malignant glioma: ESMO clinical recommendations for diagnosis, treatment and follow-up. Ann Oncol 2009;20 Suppl 4:126–8. DOI: 10.1093/annonc/mdp151.Hanif F., Muzaffar K., Perveen K. et al. Glioblastoma multiforme: a review of its epidemiology and pathogenesis through clinical presentation and treatment. Asian Pac J Cancer Prev 2017;18(1):3–9. DOI: 10.22034/APJCP.2017.18.1.3.Hanif F., Muzaffar K., Perveen K. et al. Glioblastoma multiforme: a review of its epidemiology and pathogenesis through clinical presentation and treatment. Asian Pac J Cancer Prev 2017;18(1):3–9. DOI: 10.22034/APJCP.2017.18.1.3.Davis M.E. Glioblastoma: overview of disease and treatment. Clin J Oncol Nurs 2016;20(5 Suppl):S2–8. DOI: 10.1188/16.CJON.S1.2-8.Davis M.E. Glioblastoma: overview of disease and treatment. Clin J Oncol Nurs 2016;20(5 Suppl):S2–8. DOI: 10.1188/16.CJON.S1.2-8.Klein J.P., Dietrich J. Neuroradiologic pearls for neuro-oncology. Continuum (Minneap Minn) 2017;23(6, Neurooncology): 1619–34. DOI: 10.1212/con.0000000000000543.Klein J.P., Dietrich J. Neuroradiologic pearls for neuro-oncology. Continuum (Minneap Minn) 2017;23(6, Neurooncology): 1619–34. DOI: 10.1212/con.0000000000000543.Mihovilovic M.I., Kertels O., Hänscheid H. et al. O-(2-(18F) fluoroethyl)-L-tyrosine PET for the differentiation of tumour recurrence from late pseudoprogression in glioblastoma. J Neurol Neurosurg Psychiatry 2019;90(2):238–9. DOI: 10.1136/jnnp-2017-317155.Mihovilovic M.I., Kertels O., Hänscheid H. et al. O-(2-(18F) fluoroethyl)-L-tyrosine PET for the differentiation of tumour recurrence from late pseudoprogression in glioblastoma. J Neurol Neurosurg Psychiatry 2019;90(2):238–9. DOI: 10.1136/jnnp-2017-317155.Трофимова Т.Н., Олюшин В.Е., Порсаев А.И. и др. Комплексная оценка радикальности удаления супратенториальных глиом. Лучевая диагностика и терапия 2015;(2):54–62.Trofimova T.N., Olyushin V.E., Porsaev A.I. et al. Complex assesement of radical resection of supratentorial gliomas. Luchevaya diagnostika i terapiya = Diagnostic Radiology and Radiotherapy 2015;(2):54–62. (In Russ.).Токарев А.С., Рак В.А., Евдокимова О.Л. и др. Оценка ранних результатов радиохирургического лечения рецидивирующих глиобластом головного мозга с использованием мультимодальной нейровизуализации. Русский медицинский журнал 2017;25(16):1200.Tokarev A.S., Rak V.A., Evdokimova O.L. et al. Evaluation of early results of radiosurgical treatment of recurrent brain glioblastomas using multimodal neuroimaging. Russkiy medicinskiy zhurnal = Russian Medical Journal 2017;25(16):1200. (In Russ.).Токарев А.С., Чувилин С.А., Степанов В.Н., Рак В.А. Роль функциональной магнитно-резонансной томографии при удалении опухолей в функционально значимых зонах головного мозга. Нейрохирургия 2017;(3):64–9.Tokarev A.S., Chuvilin S.A., Stepanov V.N., Rak V.A. Role of functional magnetic resonance imaging during removal of tumors in brain eloquent areas. Neyrokhirurgiya = Russian Journal of Neurosurgery 2017;(3):64–9. (In Russ.).Hassani D.F., Melhaoui A., Dif Y. et al. Integration of three-dimensional magnetic resonance imaging spectroscopy with the Leksell GammaPlan radiosurgical planning station for the treatment of brain tumors. Cureus 2019;11(10):e5946. DOI: 10.7759/cureus.5946.Hassani D.F., Melhaoui A., Dif Y. et al. Integration of three-dimensional magnetic resonance imaging spectroscopy with the Leksell GammaPlan radiosurgical planning station for the treatment of brain tumors. Cureus 2019;11(10):e5946. DOI: 10.7759/cureus.5946.Arora G., Sharma P., Sharma A. et al. 99mTc-methionine hybrid SPECT/CT for detection of recurrent glioma: comparison with 18F-FDG PET/CT and contrastenhanced MRI. Clin Nucl Med 2018;43(5):e132–8. DOI: 10.1097/RLU.0000000000002036.Arora G., Sharma P., Sharma A. et al. 99mTc-methionine hybrid SPECT/CT for detection of recurrent glioma: comparison with 18F-FDG PET/CT and contrastenhanced MRI. Clin Nucl Med 2018;43(5):e132–8. DOI: 10.1097/RLU.0000000000002036.Butenschön V.M., Ille S., Sollmann N. et al. Cost-effectiveness of preoperative motor mapping with navigated transcranial magnetic brain stimulation in patients with high-grade glioma. Neurosurg Focus 2018;44(6):E18. DOI: 10.3171/2018.3.FOCUS1830.Butenschön V.M., Ille S., Sollmann N. et al. Cost-effectiveness of preoperative motor mapping with navigated transcranial magnetic brain stimulation in patients with high-grade glioma. Neurosurg Focus 2018;44(6):E18. DOI: 10.3171/2018.3.FOCUS1830.Порсаев А.И., Олюшин В.Е., Трофимова Т.Н. и др. Сравнительный анализ информативности магнитно-резонансной томографии и УЗИ при оценке степени радикальности удаления супратенториальных глиом в раннем послеоперационном периоде. Российский нейрохирургический журнал им. А.Л. Поленова 2013;5(4):33–39.Porsaev A.I., Olushin V.E., Trofimova T.N. A comparative analysis of informational content of magnetic resonance tomography and ultrasound in assessing the extent of radical removal of supratentorial gliomas in the early postoperative period. Rossiyskiy neyrokhirurgicheskiy zhurnal im. A.L. Polenova = Russian Neurosurgical Journal n. a. A.L. Polenov 2013;5(4):33–39. (In Russ.).Lawrence Y.R., Wang M., Dicker A.P. et al. Early toxicity predicts long-term survival in high-grade glioma. Br J Cancer 2011;104(9):1365–71. DOI: 10.1038/bjc.2011.123.Lawrence Y.R., Wang M., Dicker A.P. et al. Early toxicity predicts long-term survival in high-grade glioma. Br J Cancer 2011;104(9):1365–71. DOI: 10.1038/bjc.2011.123.D’Amico R.S., Englander Z.K., Canoll P., Bruce J.N. Extent of resection in glioma – a review of the cutting edge. World Neurosurg 2017;103:538–49. DOI: 10.1016/j.wneu.2017.04.041.D’Amico R.S., Englander Z.K., Canoll P., Bruce J.N. Extent of resection in glioma – a review of the cutting edge. World Neurosurg 2017;103:538–49. DOI: 10.1016/j.wneu.2017.04.041.Kageji T., Nagahiro S., Uyama S. et al. Histopathological findings in autopsied glioblastoma patients treated by mixed neutron beam BNCT. J Neurooncol 2004;68(1):25–32. DOI: 10.1023/b:neon.0000024725.31515.22.Kageji T., Nagahiro S., Uyama S. et al. Histopathological findings in autopsied glioblastoma patients treated by mixed neutron beam BNCT. J Neurooncol 2004;68(1):25–32. DOI: 10.1023/b:neon.0000024725.31515.22.Lacroix M., Abi-Said D., Fourney D.R. et al. A multivariate analysis of 416 patients with glioblastoma multiforme: prognosis, extent of resection, and survival. J Neurosurg 2001;95(2):190–8. DOI: 10.3171/jns.2001.95.2.0190.Lacroix M., Abi-Said D., Fourney D.R. et al. A multivariate analysis of 416 patients with glioblastoma multiforme: prognosis, extent of resection, and survival. J Neurosurg 2001;95(2):190–8. DOI: 10.3171/jns.2001.95.2.0190.de Leeuw C.N., Vogelbaum M.A. Supratotal resection in glioma: a systematic review. Neuro Oncol 2019;21(2):179–88. DOI: 10.1093/neuonc/noy166.de Leeuw C.N., Vogelbaum M.A. Supratotal resection in glioma: a systematic review. Neuro Oncol 2019;21(2):179–88. DOI: 10.1093/neuonc/noy166.Grabowski M.M., Recinos P.F., Nowacki A.S. et al. Residual tumor volume versus extent of resection: predictors of survival after surgery for glioblastoma. J Neurosurg 2014;121(5):1115–23. DOI: 10.3171/2014.7.JNS132449.Grabowski M.M., Recinos P.F., Nowacki A.S. et al. Residual tumor volume versus extent of resection: predictors of survival after surgery for glioblastoma. J Neurosurg 2014;121(5):1115–23. DOI: 10.3171/2014.7.JNS132449.Sanai N., Berger M.S. Surgical oncology for gliomas: the state of the art. Nat Rev Clin Oncol 2018;15(2):112–25. DOI: 10.1038/nrclinonc.2017.171.Sanai N., Berger M.S. Surgical oncology for gliomas: the state of the art. Nat Rev Clin Oncol 2018;15(2):112–25. DOI: 10.1038/nrclinonc.2017.171.Chaichana K.L., Jusue-Torres I., Navarro-Ramirez R. et al. Establishing percent resection and residual volume thresholds affecting survival and recurrence for patients with newly diagnosed intracranial glioblastoma. Neuro Oncol 2014;16(1):113–22. DOI: 10.1093/neuonc/not137.Chaichana K.L., Jusue-Torres I., Navarro-Ramirez R. et al. Establishing percent resection and residual volume thresholds affecting survival and recurrence for patients with newly diagnosed intracranial glioblastoma. Neuro Oncol 2014;16(1):113–22. DOI: 10.1093/neuonc/not137.Weller M., van den Bent M., Hopkins K. et al. EANO guideline for the diagnosis and treatment of anaplastic gliomas and glioblastoma. Lancet Oncol 2014;15(9):e395–403. DOI: 10.1016/S1470-2045(14)70011-7.Weller M., van den Bent M., Hopkins K. et al. EANO guideline for the diagnosis and treatment of anaplastic gliomas and glioblastoma. Lancet Oncol 2014;15(9):e395–403. DOI: 10.1016/S1470-2045(14)70011-7.Kyritsis A.P., Levin V.A. An algorithm for chemotherapy treatment of recurrent glioma patients after temozolomide failure in the general oncology setting. Cancer Chemother Pharmacol 2011;67(5):971–83. DOI: 10.1007/s00280-011-1617-9.Kyritsis A.P., Levin V.A. An algorithm for chemotherapy treatment of recurrent glioma patients after temozolomide failure in the general oncology setting. Cancer Chemother Pharmacol 2011;67(5):971–83. DOI: 10.1007/s00280-011-1617-9.Taal W., Bromberg J.E., van den Bent M.J. Chemotherapy in glioma. CNS Oncol 2015;4(3):179–92. DOI: 10.2217/cns.15.2.Taal W., Bromberg J.E., van den Bent M.J. Chemotherapy in glioma. CNS Oncol 2015;4(3):179–92. DOI: 10.2217/cns.15.2.Van den Bent M.J. Interobserver variation of the histopathological diagnosis in clinical trials on glioma: a clinician’s perspective. Acta Neuropathol 2010;120(3):297–304. DOI: 10.1007/s00401-010-0725-7.Van den Bent M.J. Interobserver variation of the histopathological diagnosis in clinical trials on glioma: a clinician’s perspective. Acta Neuropathol 2010;120(3):297–304. DOI: 10.1007/s00401-010-0725-7.Yung W.K., Albright R.E., Olson J. et al. A phase II study of temozolomide vs. procarbazine in patients with glioblastoma multiforme at first relapse. Br J Cancer 2000;83(5):588–93. DOI: 10.1054/bjoc.2000.1316.Yung W.K., Albright R.E., Olson J. et al. A phase II study of temozolomide vs. procarbazine in patients with glioblastoma multiforme at first relapse. Br J Cancer 2000;83(5):588–93. DOI: 10.1054/bjoc.2000.1316.Stupp R., Hegi M.E., Mason W.P. et al. Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTCNCIC trial. Lancet Oncol 2009;10(5):459–66. DOI: 10.1016/s1470-2045(09)70025-7.Stupp R., Hegi M.E., Mason W.P. et al. Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTCNCIC trial. Lancet Oncol 2009;10(5):459–66. DOI: 10.1016/s1470-2045(09)70025-7.Perry J.R., Rizek P., Cashman R. et al. Temozolomide rechallenge in recurrent malignant glioma by using a continuous temozolomide schedule: the “rescue” approach. Cancer 2008;113(8):2152–7. DOI: 10.1002/cncr.23813.Perry J.R., Rizek P., Cashman R. et al. Temozolomide rechallenge in recurrent malignant glioma by using a continuous temozolomide schedule: the “rescue” approach. Cancer 2008;113(8):2152–7. DOI: 10.1002/cncr.23813.Shin J.Y., Diaz A.Z. Utilization and impact of adjuvant therapy in anaplastic oligodendroglioma: an analysis on 1692 patients. J Neurooncol 2016;129(3):567–75. DOI: 10.1007/s11060-016-2212-z.Shin J.Y., Diaz A.Z. Utilization and impact of adjuvant therapy in anaplastic oligodendroglioma: an analysis on 1692 patients. J Neurooncol 2016;129(3):567–75. DOI: 10.1007/s11060-016-2212-z.Brada M., Stenning S., Gabe R. et al. Temozolomide versus procarbazine, lomustine, and vincristine in recurrent high-grade glioma. J Clin Oncol 2010;28(30):4601–8. DOI: 10.1200/JCO.2009.27.1932.Brada M., Stenning S., Gabe R. et al. Temozolomide versus procarbazine, lomustine, and vincristine in recurrent high-grade glioma. J Clin Oncol 2010;28(30):4601–8. DOI: 10.1200/JCO.2009.27.1932.Van Den Bent M.J., Erdem-Eraslan L., Idbaih A. et al. MGMT-STP27 methylation status as predictive marker for response to PCV in anaplastic oligodendrogliomas and oligoastrocytomas. A report from EORTC study 26951. Clin Cancer Res 2013;19(19):5513–22. DOI: 10.1158/1078-0432.CCR-13-1157.Van Den Bent M.J., Erdem-Eraslan L., Idbaih A. et al. MGMT-STP27 methylation status as predictive marker for response to PCV in anaplastic oligodendrogliomas and oligoastrocytomas. A report from EORTC study 26951. Clin Cancer Res 2013;19(19):5513–22. DOI: 10.1158/1078-0432.CCR-13-1157.Ashby L.S., Smith K.A., Stea B. Gliadel wafer implantation combined with standard radiotherapy and concurrent followed by adjuvant temozolomide for treatment of newly diagnosed high-grade glioma: a systematic literature review. World J Surg Oncol 2016;14(1):225. DOI: 10.1186/s12957-016-0975-5.Ashby L.S., Smith K.A., Stea B. Gliadel wafer implantation combined with standard radiotherapy and concurrent followed by adjuvant temozolomide for treatment of newly diagnosed high-grade glioma: a systematic literature review. World J Surg Oncol 2016;14(1):225. DOI: 10.1186/s12957-016-0975-5.Izquierdo C., Joubert B., Ducray F. Anaplastic gliomas in adults: an update. Curr Opin Oncol 2017;29(6):434–42. DOI: 10.1097/cco.0000000000000409.Izquierdo C., Joubert B., Ducray F. Anaplastic gliomas in adults: an update. Curr Opin Oncol 2017;29(6):434–42. DOI: 10.1097/cco.0000000000000409.Wheeler C.J. Dendritic cell vaccines to combat glioblastoma. Expert Rev Neuroth 2010;10(4):483–6. DOI: 10.1586/ern.10.26.Wheeler C.J. Dendritic cell vaccines to combat glioblastoma. Expert Rev Neuroth 2010;10(4):483–6. DOI: 10.1586/ern.10.26.Carrillo J.A., Hsu F.P.K., Delashaw J., Bota D.A. Efficacy and safety of bevacizumab and etoposide combination in patients with recurrent malignant gliomas who have failed bevacizumab. Rev Health Care 2014;5(1):23–32. DOI: 10.7175/rhc.v5i1.668.Carrillo J.A., Hsu F.P.K., Delashaw J., Bota D.A. Efficacy and safety of bevacizumab and etoposide combination in patients with recurrent malignant gliomas who have failed bevacizumab. Rev Health Care 2014;5(1):23–32. DOI: 10.7175/rhc.v5i1.668.Chen R., Cohen A.L., Colman H. Targeted therapeutics in patients with high-grade gliomas: past, present, and future. Curr Treat Options Oncol 2016;17(8):42. DOI: 10.1007/s11864-016-0418-0.Chen R., Cohen A.L., Colman H. Targeted therapeutics in patients with high-grade gliomas: past, present, and future. Curr Treat Options Oncol 2016;17(8):42. DOI: 10.1007/s11864-016-0418-0.Ameratunga M., Pavlakis N., Wheeler H. et al. Anti-angiogenic therapy for highgrade glioma. Cochrane Database Syst Rev 2018;11(11):CD008218. DOI: 10.1002/14651858.CD008218.pub4.Ameratunga M., Pavlakis N., Wheeler H. et al. Anti-angiogenic therapy for highgrade glioma. Cochrane Database Syst Rev 2018;11(11):CD008218. DOI: 10.1002/14651858.CD008218.pub4.Batchelor T.T., Mulholland P., Neyns B. et al. Phase III randomized trial comparing the efficacy of cediranib as monotherapy, and in combination with lomustine, versus lomustine alone in patients with recurrent glioblastoma. J Clin Oncol 2013;31(26):3212–8. DOI: 10.1200/JCO.2012.47.2464.Batchelor T.T., Mulholland P., Neyns B. et al. Phase III randomized trial comparing the efficacy of cediranib as monotherapy, and in combination with lomustine, versus lomustine alone in patients with recurrent glioblastoma. J Clin Oncol 2013;31(26):3212–8. DOI: 10.1200/JCO.2012.47.2464.Bokstein F., Blumenthal D.T., Corn B.W. et al. Stereotactic radiosurgery (SRS) in high-grade glioma: judicious selection of small target volumes improves results. J Neurooncol. 2016;126(3):551–7. DOI: 10.1007/s11060-015-1997-5.Bokstein F., Blumenthal D.T., Corn B.W. et al. Stereotactic radiosurgery (SRS) in high-grade glioma: judicious selection of small target volumes improves results. J Neurooncol. 2016;126(3):551–7. DOI: 10.1007/s11060-015-1997-5.Clark G.M., McDonald A.M., Nabors L.B. et al. Hypofractionated stereotactic radiosurgery with concurrent bevacizumab for recurrent malignant gliomas: the University of Alabama at Birmingham experience. Neurooncol Pract. 2014;1(4):172–177. PMID: 26034629. DOI: 10.1093/nop/npu028.Clark G.M., McDonald A.M., Nabors L.B. et al. Hypofractionated stereotactic radiosurgery with concurrent bevacizumab for recurrent malignant gliomas: the University of Alabama at Birmingham experience. Neurooncol Pract. 2014;1(4):172–177. PMID: 26034629. DOI: 10.1093/nop/npu028.Chinot O.L., Wick W., Mason W. et al. Bevacizumab plus radiotherapy-temozolomide for newly diagnosed glioblastoma. N Engl J Med 2014;370(8):709–22.Chinot O.L., Wick W., Mason W. et al. Bevacizumab plus radiotherapy-temozolomide for newly diagnosed glioblastoma. N Engl J Med 2014;370(8):709–22.Field K.M., King M.T., Simes J. et al. Health-related quality of life outcomes from CABARET: a randomized phase 2 trial of carboplatin and bevacizumab in recurrent glioblastoma. J Neurooncol 2017;133(3):623–31. DOI: 10.1007/s11060-017-2479-8.Field K.M., King M.T., Simes J. et al. Health-related quality of life outcomes from CABARET: a randomized phase 2 trial of carboplatin and bevacizumab in recurrent glioblastoma. J Neurooncol 2017;133(3):623–31. DOI: 10.1007/s11060-017-2479-8.Andronesi O.C., Loebel F., Bogner W. et al. Treatment Response Assessment in IDH-mutant glioma patients by noninvasive 3D functional spectroscopic mapping of 2-hydroxyglutarate. Clin Cancer Res 2016;22(7):1632–41. DOI: 10.1158/1078-0432.CCR-15-0656.Andronesi O.C., Loebel F., Bogner W. et al. Treatment Response Assessment in IDH-mutant glioma patients by noninvasive 3D functional spectroscopic mapping of 2-hydroxyglutarate. Clin Cancer Res 2016;22(7):1632–41. DOI: 10.1158/1078-0432.CCR-15-0656.Johnson B.E., Mazor T., Hong C. et al. Mutational analysis reveals the origin and therapy-driven evolution of recurrent glioma. Science 2014;343(6167):189–93. DOI: 10.1126/science.1239947.Johnson B.E., Mazor T., Hong C. et al. Mutational analysis reveals the origin and therapy-driven evolution of recurrent glioma. Science 2014;343(6167):189–93. DOI: 10.1126/science.1239947.Picca A., Berzero G., Di Stefano A.L., Sanson M. The clinical use of IDH1 and IDH2 mutations in gliomas. Expert Rev Mol Diagn 2018;18(12):1041–51. DOI: 10.1080/14737159.2018.1548935.Picca A., Berzero G., Di Stefano A.L., Sanson M. The clinical use of IDH1 and IDH2 mutations in gliomas. Expert Rev Mol Diagn 2018;18(12):1041–51. DOI: 10.1080/14737159.2018.1548935.Климанов В.А. Радиобиологическое и дозиметрическое планирование лучевой и радионуклидной терапии. Ч. 2. Лучевая терапия пучками протонов, ионов, нейтронов и пучками с модулированной интенсивностью, стереотаксис, брахитерапия, радионуклидная терапия, оптимизация, гарантия. М.: НИЯУ МИФИ, 2011. 604 c.Klimanov V.A. Radiobiological and dosimetric planning of radiation and radionuclide therapy. Part 2. Radiation therapy with proton, ion, neutron beams and beams with modulated intensity, stereotaxis, brachytherapy, radionuclide therapy, optimization, guarantee. Moscow: NRNU MEPHI, 2011. 604 p. (In Russ.).Bergonie J., Tribondeau L. De quelques resultats de la radiotherapie et essai de fixation d’une technique rationnelle. Comptes Rendus des Seances de l’Academie des Sciences. 1906;143:983–5.Bergonie J., Tribondeau L. De quelques resultats de la radiotherapie et essai de fixation d’une technique rationnelle. Comptes Rendus des Seances de l’Academie des Sciences. 1906;143:983–5.Dalesandro M.F., Andre J.B. Posttreatment Evaluation of Brain Gliomas. Neuroimaging Clin N Am 2016;26(4):581–99. DOI: 10.1016/j.nic.2016.06.007.Dalesandro M.F., Andre J.B. Posttreatment Evaluation of Brain Gliomas. Neuroimaging Clin N Am 2016;26(4):581–99. DOI: 10.1016/j.nic.2016.06.007.Sourati A., Ameri A., Malekzadeh M. Radiation brain injury. In: Acute side effects radiation therapy. Springer, 2017. Pp. 27–37. DOI: 10.1007/978-3-319-55950-6_3.Sourati A., Ameri A., Malekzadeh M. Radiation brain injury. In: Acute side effects radiation therapy. Springer, 2017. Pp. 27–37. DOI: 10.1007/978-3-319-55950-6_3.Malmström A., Grønberg B.H., Marosi C. et al. Temozolomide versus standard 6-week radiotherapy versus hypofractionated radiotherapy in patients older than 60 years with glioblastoma: the Nordic randomised, phase 3 trial. Lancet Oncol 2012;13(9): 916–26. DOI: 10.1016/s1470-2045(12)70265-6.Malmström A., Grønberg B.H., Marosi C. et al. Temozolomide versus standard 6-week radiotherapy versus hypofractionated radiotherapy in patients older than 60 years with glioblastoma: the Nordic randomised, phase 3 trial. Lancet Oncol 2012;13(9): 916–26. DOI: 10.1016/s1470-2045(12)70265-6.Warren L.E.G., Bussiére M.R., Shih H.A. Radiation therapy for malignant gliomas: current options. In: Malignant brain tumors. Ed. by J.M. Gunel, J.M. Piepmeier, J.M. Baehring. Springer, 2016. Pp. 217–231. DOI: 10.1007/978-3-319-49864-5_14.Warren L.E.G., Bussiére M.R., Shih H.A. Radiation therapy for malignant gliomas: current options. In: Malignant brain tumors. Ed. by J.M. Gunel, J.M. Piepmeier, J.M. Baehring. Springer, 2016. Pp. 217–231. DOI: 10.1007/978-3-319-49864-5_14.

The authors declare that there are no conflicts of interest present.