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Radiotherapy of glioblastoma 15 years after the landmark Stupp’s trial: more controversies than standards? Cover

Radiotherapy of glioblastoma 15 years after the landmark Stupp’s trial: more controversies than standards?

Radiology and Oncology
Volume 52 (2018): Issue 2 (June 2018)
By:
Open Access
|Jun 2018

Figures & Tables

Figure 1

An example of an RT treatment plan (color wash display of isodoses with a minimal dose of 57 Gy, that is 95% of the prescribed dose of 60 Gy) in three planes. A RT plan for the same patient was prepared using a simultaneous integrated boost (left) and sequential boost (right). Target volumes are shown in blue contour (yellow labeled arrows). Dose assignment to the “PTV2-boost” target volume is the same in boost cases, 30 × 2.0 Gy. With sequential boost, overtreatment (red arrows) is observed in the area where a lower dose was prescribed.
An example of an RT treatment plan (color wash display of isodoses with a minimal dose of 57 Gy, that is 95% of the prescribed dose of 60 Gy) in three planes. A RT plan for the same patient was prepared using a simultaneous integrated boost (left) and sequential boost (right). Target volumes are shown in blue contour (yellow labeled arrows). Dose assignment to the “PTV2-boost” target volume is the same in boost cases, 30 × 2.0 Gy. With sequential boost, overtreatment (red arrows) is observed in the area where a lower dose was prescribed.

Recommendations for target definition according to EORTC, RTOG and ESTRO-ACROP

Contouring approachDose prescriptionGTVCTV
EORTC single phase30 × 2.0 GyResection cavity + residual T1 enhancementGTV + 2 cm
RTOG two phases23 × 2.0 GyGTV1: Resection cavity + residual T1 enhancement + FLAIR abnormality (oedema)CTV1 = GTV1 + 2 cm (the margin is 2.5 cm in cases where no oedema is presented)
+ 7 × 2.0 GyGTV2: Resection cavity + residual T1 enhancementGTV2 + 2 cm
ESTRO-ACROP30 × 2.0 GyResection cavity + residual T1 enhancement + FLAIR abnormality (oedema) for secondary glioblasomasGTV + 2 cm
DOI: https://doi.org/10.2478/raon-2018-0023 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099
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Language: English
Page range: 121 - 128
Submitted on: Nov 7, 2017
Accepted on: Mar 12, 2018
Published on: Jun 6, 2018
Published by: Association of Radiology and Oncology
In partnership with: Paradigm Publishing Services
Publication frequency: 4 times per year
Keywords:
glioblastoma,
radiation therapy,
controversy,
target volumes,
radiotherapy dosage
Related subjects:
Medicine,
Clinical medicine,
Internal medicine,
Haematology, oncology,
Radiology

© 2018 Tomas Kazda, Adam Dziacky, Petr Burkon, Petr Pospisil, Marek Slavik, Zdenek Rehak, Radim Jancalek, Pavel Slampa, Ondrej Slaby, Radek Lakomy, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

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