Radiotherapy guidelines for gliomas: 2025 update

Gliomas are the most frequent malignant primary brain tumours in adults. The proximity of organs at risk, the infiltrating nature, and the radioresistance of gliomas have to be taken into account in the choice of prescribed dose and technique of radiotherapy. The management of glioma patients is based on clinical factors (age, Karnofsky performance status) and tumour characteristics (histology, molecular biology, tumour location), and strongly depends on available and associated treatments, such as surgery, radiotherapy, and chemotherapy. The knowledge of molecular biomarkers is currently essential; they are increasingly evolving as additional factors that facilitate diagnostics and therapeutic decision-making. We present the update of the recommendations of the Société française de radiothérapie oncologique (the French Society for Radiation Oncology) on the indications and the technical procedures for performing radiotherapy in patients with gliomas.