Preoperative Radiosurgery for the Treatment of High Grade Glioma, NeoGlioma Trial

Eligibility Criteria

• * Age \>= 18 years
• * Clear clinical and radiographic evidence of primary high grade glioma (HGG) as judged by the Mayo multidisciplinary neuro-oncology team (World Health Organization \[WHO\] grade III-IV, including glioblastoma) regardless of IDH and MGMT status
• * Patients who underwent a previous biopsy confirming high grade glioma are eligible for enrollment
• * Planned neurosurgical resection of tumor
• * Judged to not be at risk of significant clinical risk (i.e. herniation) with radiation-induced edema prior to resection
• * Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0, 1, or 2
• * Negative pregnancy test done =\< 14 days prior to registration, for women of childbearing potential only. Patients over 50 years of age who decline pregnancy testing are still eligible without a pregnancy test.
• * Ability to complete questionnaire(s) by themselves or with assistance
• * Provide written informed consent
• * Willing to receive adjuvant radiotherapy at enrolling institution
• * Willing to provide tissue and/or blood samples for correlative research purposes
• * Any of the following:
• * Pregnant women
• * Nursing women who are unwilling to cease during therapy
• * Men or women of childbearing potential who are unwilling to employ adequate contraception
• * Prior history of cranial radiotherapy
• * Unwillingness to participate in study
• * Investigator discretion that enrollment on the study would pose undo harm or risk to the patient
• * Non-MRI compatible implanted medical device
• * Use of systemic anti-cancer therapy within the previous 3 months
• * Medical contraindication to craniotomy and tumor resection
• * Pathologic confirmation of grade I-II glioma, brain metastasis, or other brain tumor
• * Note: Patients with a history of grade I-II glioma are eligible if they have only received surgery as treatment and now there is concern for transformation to grade III-IV tumor
• * Primary spinal cord glioma or primary brainstem glioma
• * Residual tumor of excessive volume or eloquent location per investigator discretion
• * Patients who are unwilling or unable to comply with study procedures