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Current Understanding of Epidemiology, Genetic Etiology and Treatment of Gliomas from Indian Population

Rajib Mukherjee, Tapas K Das, Kaushik Roy and Joydeep Mukherjee

Tumors of the central nervous system (CNS) consist of 1-2% of the total cancer spectrum. Gliomas are the most common tumors within the CNS. These tumors originate from glial cells or glial precursor cells. Tumors originates from astroglial cells are known as astrocytoma, oligodendroglioma originates from oligodendroglial cells, oligoastrocytoma are mixed tumor containing cellular property of both astrocytes and oligodendrocytes and ependymal cells gives rise to ependymoma. The World Health Organization (WHO) classification of central nervous system tumors separates glioma into four grades, in which grade I and II are defined as low grade whereas grade III and IV are classified as high grade (also known as malignant glioma). Malignant glioma includes anaplastic glioma (anaplastic oligodendroglioma, anaplastic astrocytoma, and anaplastic oligoastrocytoma) and glioblastoma. With current treatment modality, survival of patients with newly diagnosed glioblastoma is around 12–16 months. The treatment strategy includes surgery followed by adjuvant radiation and chemotherapy. From 2005, a secondgeneration oral alkylating agent known as Temozolomide (TMZ) became standard of care in the treatment of malignant glioma patients worldwide including India. In this current review, we focused on epidemiology, molecular biology and management of gliomas emerged from India.