Clinical practice guidelines for the diagnosis and treatment of diffuse glioma-related epilepsy: 2025 update
Diffuse glioma-related epilepsy (dGRE) frequently presents with epilepsy as the initial symptom and is closely associated with tumor progression or recurrence, imposing significant social and psychological burdens on patients. The pathogenesis of dGRE is highly complex, involving both peritumoral microenvironmental mechanisms and tumor-intrinsic factors. Diagnosis requires a comprehensive approach integrating neuroimaging, EEG, molecular biomarkers, and spatial correlation between the tumor and the epileptogenic zone. Management aims to control seizures and improve prognosis. Non-enzyme-inducing anti-seizure medications (ASMs), such as levetiracetam and lacosamide, are recommended as first-line therapy, while valproic acid serves mainly as a second-line agent. Surgical resection, particularly maximal safe and supratotal removal guided by electrophysiological monitoring, significantly improves seizure outcomes. Radiotherapy, chemotherapy, and targeted agents further contribute to seizure control. The updated 2025 Chinese clinical practice guidelines incorporate recent advances in ASM use, postoperative withdrawal strategies, and multidisciplinary treatment algorithms. These updates provide an evidence-based reference for standardized diagnosis and management of dGRE.
Authors
- Xiaoguang Qiu (ORCID: https://orcid.org/0000-0002-6806-9827)
- Weiping Liao
- Suhui Kuang (ORCID: https://orcid.org/0009-0005-1945-3450)
- Yanhui Liu
- Xuejun Yang (ORCID: https://orcid.org/0000-0001-8429-7304)
- Ruobin Qian
- Shouwei Li (ORCID: https://orcid.org/0000-0001-8746-8121)
- Ziyi Chen (ORCID: https://orcid.org/0000-0003-0291-9435)
- Linbo Cai
- Yuanxiang Lin
- Tinghong Liu
- Shuli Liang
- Guanglong Huang
- Wei Zhang
- Hua Zhang
- Dong Zhou
- Liang Wang
- Suiqiang Zhu
- Juxiang Chen
- Yonggao Mou
- Guojun Zhang
- Gan You
- Xiong Han
- Jinsong Wu
- Nu Zhang
- Guoguang Zhao
- Chunqing Zhang
- Yuguang Guan
- Yi Wang
- Zengguang Wang
- Jingwen Zhang
- Xuewu Liu
- Liangzhao Chu
- Xing Fan
- Wenling Li
- Dan Sun
- Jing Peng
- Liang Chen
- Tao Jiang
- Anhua Wu
- Wenbin Ma
- Yuping Wang
- Yangmei Chen
- Weihong Lin
- Chuanlu Jiang
- Hao Li
- Wei Yue
- Shuang Wang
- Zhiqiang Yan
- Ling Chen
- Yu Wang
- Yanchun Deng
- Jianguo Zhang
- Shichuo Li
Institutions
- Hebei Medical University (CN)
- University of Science and Technology of China (CN)
- Fujian Medical University (CN)
- Central South University (CN)
- Guiyang Medical University (CN)
- Army Medical University (CN)
- Harbin Medical University (CN)
- Sun Yat-sen University (CN)
- Second Military Medical University (CN)
- Capital Medical University (CN)
- Dalian Medical University (CN)
- Chinese Academy of Medical Sciences & Peking Union Medical College (CN)
- Sichuan University (CN)
- Peking Union Medical College Hospital (CN)
- Tianjin Medical University General Hospital (CN)
- Chinese PLA General Hospital (CN)
- Beijing Tian Tan Hospital (CN)
- West China Hospital of Sichuan University (CN)
- Second Affiliated Hospital of Guangzhou Medical University (CN)
- Beijing Sanbo Brain Hospital (CN)
- Second Affiliated Hospital of Chongqing Medical University (CN)
- Second Hospital of Hebei Medical University (CN)
- Tianjin Huanhu Hospital (CN)
- Third Affiliated Hospital of Harbin Medical University (CN)
- Affiliated Hospital of Guizhou Medical University (CN)
- Beijing Institute of Neurosurgery (CN)
- Changhai Hospital (CN)
- Shandong Provincial Hospital (CN)
- Xinqiao Hospital (CN)
- First Affiliated Hospital of Fujian Medical University (CN)
- First Affiliated Hospital of Xi'an Jiaotong University (CN)
- The First Affiliated Hospital, Sun Yat-sen University (CN)
- First Affiliated Hospital of Chinese PLA General Hospital (CN)
- Second Affiliated Hospital of Harbin Medical University (CN)
- Henan Provincial People's Hospital (CN)
- Wuhan Children's Hospital (CN)
- Beijing Children’s Hospital (CN)
- First Bethune Hospital of Jilin University (CN)
- Sun Yat-sen University Cancer Center (CN)
- Zhengzhou People's Hospital (CN)
- Beijing Tsinghua Chang Gung Hospital (CN)
- Tang Du Hospital (CN)
- International League Against Epilepsy (US)
- Huazhong University of Science and Technology Hospital (CN)
- Second Affiliated Hospital of Zhejiang University (CN)
- Xijing Hospital (CN)
- Children's Hospital of Fudan University (CN)
- Huashan Hospital (CN)
- Xiangya Hospital Central South University (CN)
- Guangdong 999 Brain Hospital (CN)
- Huazhong University of Science and Technology (CN)
- Southern Medical University (CN)
- Nanjing Medical University (CN)
- Chongqing Medical University (CN)
- China Medical University (CN)
- Guangzhou Medical University (CN)
Publication Details
- Journal
- Cancer Letters
- Published
- 2026-02-23
- DOI
- https://doi.org/10.1016/j.canlet.2026.218360
- Primary Topic
- Glioma Diagnosis and Treatment
- Type
- article
- Field-Weighted Citation Impact
- 0.00