This is truly an exciting time in the field of neuro-oncology, particularly in the area of highgrade
gliomas. The management of patients with high-grade gliomas has historically been one
of the most challenging and disheartening fields in medicine, where failure is the rule and
longevity is the exception. The jaded often state that despite purported advances in surgical
and radiotherapeutic techniques and a myriad of clinical trials of medical therapies, the survival
statistics for glioblastoma have not changed in the last three decades. The nihilism
associated with these tumors is such that some practitioners still advise against treatment or
even biopsy, recommending palliative care with the diagnosis based only on history and an
MRI scan. If the current state-of-the-art in the diagnosis and management of high-grade
gliomas was truly so bleak, there would be no reason to compile and publish a monograph on
the subject. The fact is that we have recently entered an era where real progress is being made
in our understanding and treatment of high-grade gliomas that is directly benefiting some
patients.