TY - JOUR
T1 - ESTRO-EANO guideline on target delineation and radiotherapy details for glioblastoma
AU - Niyazi, Maximilian
AU - Andratschke, Nicolaus
AU - Bendszus, Martin
AU - Chalmers, Anthony J.
AU - Erridge, Sara C.
AU - Galldiks, Norbert
AU - Lagerwaard, Frank J.
AU - Navarria, Pierina
AU - Munck af Rosenschöld, Per
AU - Ricardi, Umberto
AU - van den Bent, Martin J.
AU - Weller, Michael
AU - Belka, Claus
AU - Minniti, Giuseppe
N1 - Publisher Copyright: © 2023 The Authors
PY - 2023/7
Y1 - 2023/7
N2 - Background and Purpose: Target delineation in glioblastoma is still a matter of extensive research and debate. This guideline aims to update the existing joint European consensus on delineation of the clinical target volume (CTV) in adult glioblastoma patients. Material and Methods: The ESTRO Guidelines Committee identified 14 European experts in close interaction with the ESTRO clinical committee and EANO who discussed and analysed the body of evidence concerning contemporary glioblastoma target delineation, then took part in a two-step modified Delphi process to address open questions. Results: Several key issues were identified and are discussed including i) pre-treatment steps and immobilisation, ii) target delineation and the use of standard and novel imaging techniques, and iii) technical aspects of treatment including planning techniques and fractionation. Based on the EORTC recommendation focusing on the resection cavity and residual enhancing regions on T1-sequences with the addition of a reduced 15 mm margin, special situations are presented with corresponding potential adaptations depending on the specific clinical situation. Conclusions: The EORTC consensus recommends a single clinical target volume definition based on postoperative contrast-enhanced T1 abnormalities, using isotropic margins without the need to cone down. A PTV margin based on the individual mask system and IGRT procedures available is advised; this should usually be no greater than 3 mm when using IGRT.
AB - Background and Purpose: Target delineation in glioblastoma is still a matter of extensive research and debate. This guideline aims to update the existing joint European consensus on delineation of the clinical target volume (CTV) in adult glioblastoma patients. Material and Methods: The ESTRO Guidelines Committee identified 14 European experts in close interaction with the ESTRO clinical committee and EANO who discussed and analysed the body of evidence concerning contemporary glioblastoma target delineation, then took part in a two-step modified Delphi process to address open questions. Results: Several key issues were identified and are discussed including i) pre-treatment steps and immobilisation, ii) target delineation and the use of standard and novel imaging techniques, and iii) technical aspects of treatment including planning techniques and fractionation. Based on the EORTC recommendation focusing on the resection cavity and residual enhancing regions on T1-sequences with the addition of a reduced 15 mm margin, special situations are presented with corresponding potential adaptations depending on the specific clinical situation. Conclusions: The EORTC consensus recommends a single clinical target volume definition based on postoperative contrast-enhanced T1 abnormalities, using isotropic margins without the need to cone down. A PTV margin based on the individual mask system and IGRT procedures available is advised; this should usually be no greater than 3 mm when using IGRT.
UR - https://www.scopus.com/pages/publications/85153030506
U2 - 10.1016/j.radonc.2023.109663
DO - 10.1016/j.radonc.2023.109663
M3 - Article
C2 - 37059335
AN - SCOPUS:85153030506
SN - 0167-8140
VL - 184
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
M1 - 109663
ER -