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A Comparative Study of Five Target Volume Definitions for Radiotherapy in Glioblastoma Multiforme.

Kamuran Ibis1, Kubra Ozkaya Toraman1, Canan Koksal Akbas2

  • 1Department of Radiation Oncology, Institute of Oncology, Istanbul University, 34093 Istanbul, Türkiye.

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Summary

Comparing radiotherapy planning for glioblastoma multiforme (GBM), the ESTRO-EANO and EORTC target volumes reduced irradiated brain volume and preserved organs-at-risk (OARs). These protocols offer dosimetric advantages for GBM treatment.

Keywords:
glioblastoma multiformeradiotherapyvolume delineation

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Area of Science:

  • Radiation Oncology
  • Neuro-Oncology
  • Medical Physics

Background:

  • Glioblastoma multiforme (GBM) radiotherapy planning involves defining target volumes and organs-at-risk (OARs).
  • Different volume definitions can impact treatment efficacy and toxicity.
  • Optimizing target volumes is crucial for minimizing radiation exposure to healthy tissues.

Purpose of the Study:

  • To compare target volumes and OAR doses using five distinct volume definitions in GBM radiotherapy planning.
  • To evaluate dosimetric differences between two-phase and single-phase RT planning protocols.
  • To identify optimal volume definitions for improved GBM treatment outcomes.

Main Methods:

  • Rigid image fusion of CT and MRI scans from 20 GBM patients.
  • Generation of Volumetric Modulated Arc Therapy (VMAT) plans using ABTC, NCCTG/Alliance, RTOG/NRG, EORTC, and ESTRO/EANO protocols.
  • Evaluation of OAR doses and dose constraints, with statistical analysis using paired sample t-tests.

Main Results:

  • The ESTRO/EANO volume definition resulted in the smallest overall planning target volume (PTV).
  • ESTRO/EANO and ABTC protocols showed the lowest brain-PTV Dmean in the initial phase.
  • ESTRO/EANO consistently minimized OAR doses, including cochlea, brainstem, and lens, while keeping them within acceptable constraints.

Conclusions:

  • The ESTRO/EANO and EORTC target volumes demonstrate dosimetric advantages in GBM radiotherapy.
  • These protocols offer reduced irradiated brain volume and acceptable OAR preservation.
  • Further clinical validation is needed to confirm the impact of these dosimetric benefits on patient outcomes.