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Intracranial Gliomas Part III – Innovative Treatment Modalities represents the final book of three-part series focused on the diagnosis, management, and options for additional treatment of a still perplexing problem. The two prior volumes have highlighted international opinions reflecting on the past and current strategies for gliomas—including surgery and adjuvant radiation and chemotherapy approaches. The keys to future successful care of our patients with these tumors lies in many directions. First, comes increasing vigilance and early detection. Pioneering neurosurgeon Patrick Kelly, prior chair of neurosurgery at New York University, once stated that every young adult in the world should have a 10 minute whole head T2-weighted MRI as a baseline view of their brain. Early detection may be a crucial element—but then we have to have the courage to act on our suspicions, get a diagnosis, and intervene immediately. Second, surgery will remain an important way to confirm the histology until we have better brain mapping tools that can reliably define the type and grade of the tumor. Third, the practical application of our still emerging molecular knowledge may open doors that can significantly improve prognosis using specific targeted agents that get to the tumor without damaging the brain or the body. My colleague Steve Haines, Chair Emeritus at Minnesota, once told me some years ago “A difference to be a difference must make a difference.” As we continue to develop new strategies, we must make sure that any innovation has merit. The future of glioma care will require further innovation and a willingness to prove each innovation has scientific value.

L. Dade Lunsford, MD, FACS, FAANS, Pittsburgh, PA