neurooncologic

Neuro-oncology, sometimes referred to as neurooncologic in adjectival use, is a medical specialty focused on tumors and other diseases of the brain and spine, including primary brain tumors, spinal cord tumors, and metastases to the central nervous system. Practitioners coordinate care among neurosurgery, medical neuro-oncology, radiation oncology, neuropathology, neuroradiology, and rehabilitation to provide multidisciplinary management.

Most common primary CNS tumors include gliomas (such as glioblastoma multiforme, various astrocytomas, and oligodendrogliomas), meningiomas, schwannomas, ependymomas, medulloblastomas, and CNS lymphomas. Metastatic tumors from other organs are more common than primary brain tumors in adults, shaping treatment priorities in many cases.

Diagnosis relies on magnetic resonance imaging with contrast as the main tool, with biopsy used to obtain histology and molecular profiling. Modern classification integrates genetic and epigenetic features (examples include IDH mutations, 1p/19q codeletion, MGMT promoter methylation, and other biomarkers) to guide prognosis and therapy.

Treatment is multidisciplinary and individualized, often combining surgical resection or debulking when feasible, radiotherapy, and chemotherapy (such as temozolomide for many gliomas; other regimens for different tumors). Targeted therapies, anti-angiogenic agents, and immunotherapies are used selectively, and clinical trials are important for advancing options. Supportive care, including seizure management and edema control with anticonvulsants and corticosteroids, is integral to treatment.

Prognosis varies widely by tumor type and molecular features; glioblastoma, for example, typically has a poorer outcome, while some low-grade gliomas or meningiomas may be more indolent. Ongoing research in neuro-oncology aims to refine molecular classification, develop targeted and immunotherapies, and overcome barriers like the blood-brain barrier to improve outcomes.