There is renewed interest in boron neutron capture therapy of gliomas, while enthusiasm for immunotherapeutic modalities, such as interferon, has begun to wane. Basic research into glioma biology is shedding light on the proliferative pathways which may be amendable to future therapeutic manipulation. Recent evidence has confirmed the benefit of surgical excision in patients with solitary brain metastases. Great technical advances are occurring in radical skull base surgery; however, the indications for such surgery remain poorly defined, particularly for patients with malignant lesions.