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ASTRO Guideline on Radiation Therapy for WHO Grade 4 Adult-Type Diffuse Glioma

Published: Web posted June 2025

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This guideline addresses four key questions on the use of radiation therapy (RT) for management of World Health Organization (WHO) Grade 4 Adult-Type Diffuse Glioma. These questions include indications for radiation therapy (RT) and/or adjunctive therapies (e.g., systemic therapy, alternating electric field therapy), appropriate regimens for external beam RT after initial biopsy/resection including variables such as pretreatment characteristics, target volumes, technique, dose, reirradiation indications and techniques, and health disparities.

Developed in collaboration with:

  • American Association of Neurological Surgeons/Congress of Neurological Surgeons
  • American Association of Neuropathologists 
  • American Society of Clinical Oncology 
  • Society for Neuro-Oncology

Endorsed by:

  • European Society for Radiotherapy and Oncology 
  • Royal Australian and New Zealand College of Radiologists
  • Society for Neuro-Oncology

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Copyright © 2025 American Society for Radiation Oncology