Gliomas are the most frequent primary brain tumors. Their care is difficult 
because of the proximity of organs at risk. The treatment of glioblastoma 
includes surgery followed by chemoradiation with the protocol of Stupp et al. 
The addition of bevacizumab allows an increase in progression-free survival by 4 
months but it does not improve overall survival. This treatment is reserved for 
clinical trials. Intensity modulation radiotherapy may be useful to reduce the 
neurocognitive late effects in different types of gliomas. In elderly patients 
an accelerated radiotherapy 40 Gy in 15 fractions allows a similar survival to 
standard radiotherapy. O(6)-methylguanine-DNA methyltransferase (MGMT) status 
may help to choose between chemotherapy and radiotherapy. There is no standard 
for the treatment of recurrent gliomas. Re-irradiation in stereotactic 
conditions allows a median survival of 8 to 12.4 months. Anaplastic gliomas with 
1p19q mutation have a greater sensibility to chemotherapy by procarbazine, 
lomustine and vincristine. Chemoradiotherapy in these patients has become the 
standard treatment. Many studies are underway testing targeted therapies, their 
place in the therapeutic management and new radiotherapy techniques.