Radiotherapy for newly diagnosed adult high grade gliomas in the Asia Pacific Region.

Radiotherapy (RT) plays a critical role in improving survival in adult patients with newly diagnosed adult high grade gliomas (HGG). Standard protocols and treatment options have been well elucidated in widely used guidelines on glioma management like the EANO and NCCN guidelines. Given that these guidelines were formulated in high income countries (HIC) with access to the latest technologies, it is less certain whether these are carried out uniformly in the Asia Pacific region, where countries belong to varying income levels. We did a systematic review augmented by unpublished data, looking at the following points: radiotherapy protocols being used in the treatment of adult patients with newly diagnosed HGG, the extent to which they are being applied, and potential barriers, if any, to radiotherapy access. Our results show that radiotherapy protocols for HGG in the Asia Pacific region closely follow those outlined in the EANO, and to some degree, the NCCN guidelines. More work needs to be done towards creating a national patient database to provide a more accurate picture of real world application of treatment protocols, as well as addressing identified barriers to radiotherapy access in the region.