Treatment will depend on the location, extent of recurrent or progressive disease, previous management and the patient’s preferences.

There is currently no standard treatment for patients with recurrent or progressive high-grade glioma; however, treatment may include:

• repeat surgery
• radiation
• systemic therapies.

Treatment may focus on disease control or palliation, based on the extent of disease, general health or the patient’s preferences and values. The potential goals of treatment should be discussed, respecting the patient’s cultural values, and wherever possible written information should be provided.

Encourage early referral to clinical trials or accepting an invitation to participate in research.