Objective:

To comprehensively evaluate glioma management in low- and middle-income countries (LMICs) and characterize the challenges faced in these settings, particularly focusing on disparities in management and outcomes.

Approach:

Key Findings:

• Thirty studies comprising 3,463 patients from 17 LMICs were included.
• Low-grade gliomas accounted for 62.6% of tumors; high-grade gliomas represented 37.4%.
• Molecular profiling was reported in 26.7% of studies, indicating a need for improved diagnostic capabilities.
• Pooled 5-year overall survival rates were 87.8% for low-grade gliomas and 21.9% for high-grade gliomas.

Interpretation:

Glioma management in LMICs is characterized by limited access to adjuvant therapies, minimal molecular diagnostic integration, and heterogeneous survival outcomes, which significantly impact patient prognosis.

Limitations:

• Limited access to adjuvant therapies and molecular diagnostics in LMICs, which may skew survival outcomes.
• Survival outcomes in LMICs fall below those achieved in high-income countries, highlighting the need for targeted interventions.

Conclusion:

Targeted investments in radiotherapy infrastructure, chemotherapy access, and molecular diagnostic capabilities are essential to reduce global disparities in neuro-oncological care and improve patient outcomes.

Sources:

• Systematic Review Registration
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