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

Tomas Kazda

Tomas Kazda

  • Department of Radiation Oncology, Masaryk Memorial Cancer InstituteBrno, Czech Republic
  • Department of Radiation Oncology, Faculty of Medicine, Masaryk UniversityBrno, Czech Republic
  • Central European Institute of Technology, Masaryk UniversityBrno, Czech Republic
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Kazda, Tomas
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Adam Dziacky

Adam Dziacky

Faculty of Medicine, Masaryk UniversityBrno, Czech Republic
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Dziacky, Adam
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Petr Burkon

Petr Burkon

  • Department of Radiation Oncology, Masaryk Memorial Cancer InstituteBrno, Czech Republic
  • Department of Radiation Oncology, Faculty of Medicine, Masaryk UniversityBrno, Czech Republic
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Burkon, Petr
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Petr Pospisil

Petr Pospisil

  • Department of Radiation Oncology, Masaryk Memorial Cancer InstituteBrno, Czech Republic
  • Department of Radiation Oncology, Faculty of Medicine, Masaryk UniversityBrno, Czech Republic
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Pospisil, Petr
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Marek Slavik

Marek Slavik

  • Department of Radiation Oncology, Masaryk Memorial Cancer InstituteBrno, Czech Republic
  • Department of Radiation Oncology, Faculty of Medicine, Masaryk UniversityBrno, Czech Republic
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Slavik, Marek
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Zdenek Rehak

Zdenek Rehak

  • Department of Nuclear Medicine and PET Center, Masaryk Memorial Cancer, InstituteBrno, Czech Republic
  • Regional Center for Applied Molecular Oncology (RECAMO), Masaryk Memorial Cancer InstituteBrno, Czech Republic
  • Department of Comprehensive Cancer Care, Faculty of Medicine, Masaryk UniversityBrno, Czech Republic
  • Department of Comprehensive Cancer Care, Masaryk Memorial Cancer InstituteBrno, Czech Republic
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Rehak, Zdenek
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Radim Jancalek

Radim Jancalek

  • Department of Neurosurgery - St. Anne’s University Hospital Brno, Faculty of Medicine, Masaryk UniversityBrno, Czech Republic
  • Department of Neurosurgery, St. Anne’s University Hospital BrnoBrno, Czech Republic
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Jancalek, Radim
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Pavel Slampa

Pavel Slampa

  • Department of Radiation Oncology, Masaryk Memorial Cancer InstituteBrno, Czech Republic
  • Department of Radiation Oncology, Faculty of Medicine, Masaryk UniversityBrno, Czech Republic
  • Regional Center for Applied Molecular Oncology (RECAMO), Masaryk Memorial Cancer InstituteBrno, Czech Republic
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Slampa, Pavel
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Ondrej Slaby

Ondrej Slaby

  • Central European Institute of Technology, Masaryk UniversityBrno, Czech Republic
  • Department of Comprehensive Cancer Care, Faculty of Medicine, Masaryk UniversityBrno, Czech Republic
  • Department of Comprehensive Cancer Care, Masaryk Memorial Cancer InstituteBrno, Czech Republic
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Slaby, Ondrej
 oraz 
Radek Lakomy

Radek Lakomy

  • Department of Comprehensive Cancer Care, Faculty of Medicine, Masaryk UniversityBrno, Czech Republic
  • Department of Comprehensive Cancer Care, Masaryk Memorial Cancer InstituteBrno, Czech Republic
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Lakomy, Radek
  
06 cze 2018
Radiotherapy of glioblastoma 15 years after the landmark Stupp’s trial: more controversies than standards?'s Cover Image
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Kategoria artykułu: Review
Data publikacji: 06 cze 2018
Zakres stron: 121 - 128
Otrzymano: 07 lis 2017
Przyjęty: 12 mar 2018
DOI: https://doi.org/10.2478/raon-2018-0023
Słowa kluczowe
© 2018 Tomas Kazda, Adam Dziacky, Petr Burkon, Petr Pospisil, Marek Slavik, Zdenek Rehak, Radim Jancalek, Pavel Slampa, Ondrej Slaby, Radek Lakomy, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

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 approach Dose prescription GTV CTV
EORTC single phase 30 × 2.0 Gy Resection cavity + residual T1 enhancement GTV + 2 cm
RTOG two phases 23 × 2.0 Gy GTV1: 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 Gy GTV2: Resection cavity + residual T1 enhancement GTV2 + 2 cm
ESTRO-ACROP 30 × 2.0 Gy Resection cavity + residual T1 enhancement + FLAIR abnormality (oedema) for secondary glioblasomas GTV + 2 cm
Język:
Angielski
Częstotliwość wydawania:
4 razy w roku
Dziedziny czasopisma:
Medycyna, Medycyna kliniczna, Medycyna wewnętrzna, Hematologia, onkologia, Radiologia
Kanał RSS czasopisma