- Neuro-oncology is a specialized field of medicine that focuses on the study, diagnosis, and treatment of tumors affecting the brain, spinal cord, and peripheral nerves. It lies at the intersection of neurology, oncology, and neurosurgery, addressing both primary tumors of the nervous system—such as gliomas, meningiomas, and medulloblastomas—and secondary tumors that arise from cancers elsewhere in the body but metastasize to the central nervous system (CNS).
- Because the brain and spinal cord control critical bodily functions and cognitive processes, neuro-oncological diseases present unique clinical challenges in terms of diagnosis, treatment, and patient quality of life.
- A central concern in neuro-oncology is the management of primary brain tumors. Gliomas, including glioblastoma multiforme, are among the most aggressive and difficult-to-treat forms, often characterized by rapid growth, resistance to therapy, and infiltration into surrounding brain tissue. Other primary tumors, such as ependymomas and astrocytomas, vary widely in their aggressiveness and prognosis. In children, neuro-oncology also addresses specific malignancies like medulloblastomas, which are the most common malignant pediatric brain tumors. Secondary brain tumors, caused by metastasis from cancers like lung, breast, or melanoma, are even more prevalent and represent a major focus of care.
- Diagnosis in neuro-oncology integrates advanced imaging, molecular profiling, and histopathology. Magnetic resonance imaging (MRI) remains the gold standard for detecting and characterizing brain tumors, while molecular diagnostics, such as testing for IDH mutations, MGMT promoter methylation, or 1p/19q co-deletion, refine classification and guide personalized treatment strategies. These molecular markers not only improve diagnostic accuracy but also help predict prognosis and response to therapies, reflecting the integration of precision medicine into neuro-oncology.
- Treatment approaches are multidisciplinary, involving neurosurgeons, radiation oncologists, medical oncologists, and supportive care teams. Surgery is often the first line of therapy, aiming for maximal safe resection while preserving neurological function. Radiotherapy and chemotherapy, particularly with agents such as temozolomide, are commonly employed as adjuvant treatments. In recent years, novel therapies—including targeted therapies, immunotherapy, and tumor-treating fields (TTF, an innovative approach using alternating electric fields to disrupt tumor cell division)—have expanded the treatment landscape. Clinical trials continue to explore ways to overcome challenges such as the blood–brain barrier, which limits the delivery of many drugs to the CNS.
- Beyond tumor-directed therapies, neuro-oncology emphasizes symptom management and quality of life. Patients often experience seizures, headaches, cognitive impairment, and neurological deficits due to both the tumor itself and the side effects of treatment. Supportive measures, rehabilitation, and palliative care are therefore integral components of neuro-oncology practice. The field also increasingly recognizes the psychosocial impact of brain and spinal tumors, extending care to address emotional, cognitive, and social needs of patients and their families.
- Research in neuro-oncology continues to evolve rapidly, driven by advances in genomics, immunology, and imaging. Efforts to map the tumor microenvironment, understand mechanisms of resistance, and exploit novel therapeutic targets are paving the way for more effective and individualized treatments. While survival rates for many malignant brain tumors remain low, ongoing scientific and clinical progress is gradually improving outcomes and offering hope for more durable responses in the future.
