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Glioma: A Narrative Review of Treatment, Recovery, Immune Support, and Microbiota Modulation  \nGeorge B. H. Green 1, Alexis N. Cox-Holmes 1, Jonathan T. Flowers 2, Michael B. Williams 2, Anna Claire E. Potier 1, Jeri L. Brandom 2, Stephen A. Watts 2, Raymond Luke 3, Jennifer S. Yu 4 and Braden C. McFarland 1, *  \nAcademic Editor: Mariusz Chabowski  \nReceived: 13 February 2026  \nRevised: 16 March 2026  \nAccepted: 17 March 2026  \nPublished: 19 March 2026  \nCopyright: © 2026 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.  \n1 Department of Cell, Developmental and Integrative Biology, University of Alabama at Birmingham, Birmingham, AL 35294, USA  \n2 Department of Biology, University of Alabama at Birmingham, Birmingham, AL 35294, USA  \n3 Department of Radiation Oncology, Weill Cornell Medical College, New York, NY 10065, USA  \n4 Department of Radiation Oncology, Department of Cancer Biology, Cleveland Clinic, Cleveland, OH 44195, USA  \n* [Correspondence: bdcox@uab.edu](Correspondence: bdcox@uab.edu)  \nAbstract  \nThis narrative review aims to explore the relationship between glioma and nutrition throughout stages of treatment and recovery. Gliomas are aggressive brain tumors that significantly impair quality of life and present treatment challenges. There has been a growing interest regarding the gut–brain axis and the microbiome, particularly their roles in modulating immune function and influencing the response to cancer treatment. This review examines how specific nutritional approaches may assist patients throughout the course of chemotherapy, radiation, immunotherapy, surgical intervention, and the recovery process. It also addresses the potential for integrative nutritional approaches to complement conventional treatment and improve clinical outcomes. Emerging evidence suggests that nutrition may influence immune function, treatment-related side effects, and the tumor microenvironment, in part through effects on the gut microbiota. Nutritional support during therapy has been linked to increased strength, decreased inflammation, and improved treatment tolerance. Dietary patterns may influence gut–brain interactions and systemic immune responses, opening the potential to improve therapeutic outcomesin glioma. In summary, nutrition may represent an important supportive component of glioma care, while microbiota-mediated and metabolic dietary strategies remain areas of active investigation. Further clinical studies are needed to determine whether specific nutritional interventions can improve survival, treatment response, or quality of life inpatients with glioma.  \nKeywords: glioma; nutrition; microbiota; surgery; wound healing  \n1. Introduction  \nGliomas, tumors originating from glial cells in the brain, are the most common type of primary tumor found within the central nervous system (CNS) [1] . These tumors account for 25% of all brain tumors and 80% of all malignant brain tumors, with the most aggressive being glioblastoma (GBM) . Gliomas are categorized based on the phenotypic characteristics of the cells of origin—oligodendroglioma, ependymoma, or astrocytoma—as well as by grade, grades 1–4, and molecular features: for example, isocitrate dehydrogenase (IDH)  \nmutation status or histone H3K27 mutation status [2,3] . As the glioma becomes more aggressive, the prognosis for the patient rapidly declines. Currently, the median survival for patients with GBM at the time of diagnosis is 15–16 months [4] .  \nTherapeutic options depend on the location and grade of the tumor; however, treatment often consists of surgical resection and subsequent chemotherapy and radiation. Surgery is typically the primary treatment for brain tumors as it establishes a diagnosis and relieves mass effect. The use of adjuvant treatments such as chemother","cbCairF1FKgwAWTj","https://ap.wps.com/l/cbCairF1FKgwAWTj","pdf",1320530,36,"English","# Introduction\n## Clinical Context: Glioma Treatment Course and Associated Nutritional Challenges\n## Surgical Resection and Perioperative Nutritional Vulnerability","[{\"question\":\"How does nutrition relate to glioma across different care phases?\",\"answer\":\"The review describes nutrition as influencing supportive outcomes from perioperative management through chemotherapy, radiation, immunotherapy, and recovery, with potential effects on immune function and treatment tolerance.\"},{\"question\":\"Why are the gut-brain axis and microbiome emphasized in glioma nutrition research?\",\"answer\":\"They are highlighted because emerging evidence suggests microbiota-mediated mechanisms can modulate immune activity and contribute to how patients respond to cancer treatment.\"},{\"question\":\"What potential benefits does nutritional support have during therapy?\",\"answer\":\"Nutritional support during treatment has been linked to increased strength, decreased inflammation, and improved tolerance of therapeutic regimens.\"}]","Dietary and Nutritional Strategies for Patients with Glioma - A Narrative Review of Treatment, Recovery, Immune Support, and Microbiota Modulation | PDF",1790100603,91]