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Radiotherapy in Glioblastoma: the Past, the Present and the Future
1Genesis Cancer Care, Darlinghurst, Sydney, Australia; Northern Clinical School, University of Sydney Medical School, St Leonards, Sydney, Australia.
Clinical Oncology (Royal College of Radiologists (Great Britain))
|October 17, 2016
Summary
Radiotherapy remains crucial for glioblastoma treatment, evolving from early 2D methods to advanced techniques like IMRT and VMAT. Continued innovation in radiation oncology is vital for improving patient survival and reducing treatment toxicity.
Area of Science:
- Neuro-oncology
- Radiation Oncology
- Medical Physics
Background:
- Glioblastoma treatment relies heavily on surgery and radiotherapy.
- Radiotherapy techniques have undergone significant evolution over the past six decades.
- Advances aim to improve efficacy and minimize toxicity in glioblastoma management.
Purpose of the Study:
- To review the historical and current utility of radiotherapy in glioblastoma treatment.
- To discuss advancements in radiotherapy techniques and their impact.
- To explore current controversies and future directions in glioblastoma radiotherapy.
Main Methods:
- Review of historical radiotherapy techniques (2D, dose escalation).
- Analysis of modern techniques: intensity-modulated radiotherapy (IMRT), image-guided radiotherapy (IGRT), volumetric-modulated arc therapy (VMAT).
- Discussion of current clinical controversies and emerging therapeutic strategies.
Main Results:
- Significant evolution from basic 2D radiotherapy to sophisticated techniques like IMRT, IGRT, and VMAT.
- Concomitant chemotherapy has become standard alongside radiotherapy.
- Ongoing debates regarding margin size, re-irradiation, and elderly patient treatment persist.
Conclusions:
- Radiotherapy is indispensable for glioblastoma, complementing surgery, chemotherapy, and immunotherapy.
- Radiation oncology must continuously innovate in delivery, target definition, and dosage.
- Improvements in radiotherapy are essential for enhancing glioblastoma patient survival and managing treatment-related toxicities.
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