ESTRO-ACROP guideline "target delineation of glioblastomas"

Niyazi M, Brada M, Chalmers AJ, Combs SE, Erridge SC, Fiorentino A, Grosu AL, Lagerwaard FJ, Minniti G, Mirimanoff RO, Ricardi U, Short SC, Weber DC, Belka C (2016)

Publication Type: Journal article

Publication year: 2016

Journal

Radiotherapy and Oncology Elsevier

Book Volume: 118

Pages Range: 35-42

Journal Issue: 1

DOI: 10.1016/j.radonc.2015.12.003

Abstract

Background and purpose Target delineation in glioblastoma (GBM) varies substantially between different institutions and several consensus statements are available. This guideline aims to develop a joint European consensus on the delineation of the clinical target volume in patients with a glioblastoma (GBM). Material and methods A literature search was conducted in PubMed that evaluated adults with GBM. Both MeSH terms and text words were used and the following search strategy was applied: ("Glioblastoma/radiotherapy" [MeSH] OR "glioblastoma" OR "malignant glioma" OR high-grade glioma) AND ((delineation) OR (target volume) OR (CTV) OR (PTV) OR (margin) OR (recurrence pattern) OR (contouring) OR (organs at risk)). In parallel, abstracts from ESTRO and ASTRO 2010-2015 were analysed and separately reviewed. The ACROP committee identified 14 European experts in close interaction with the ESTRO clinical committee who discussed and analysed the body of evidence concerning GBM target delineation. Results Several key issues were identified and are discussed including (i) pre-treatment steps and immobilization, (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 20 mm margin, special situations are presented with corresponding potential adaptations depending on the specific clinical situation. Conclusions Currently, based on the EORTC consensus, a single clinical target volume definition based on postoperative T1/T2 FLAIR abnormalities is recommended, using isotropic margins without the need to cone down. A PTV margin based on the individual mask system and IGRT procedures available is advised, usually of the order of 3-5 mm.

Involved external institutions

Ludwig-Maximilians-Universität (LMU) DE Germany (DE) The University of Liverpool GB United Kingdom (GB) University of Glasgow GB United Kingdom (GB) Technische Universität München (TUM) DE Germany (DE) University of Edinburgh GB United Kingdom (GB) Ospedale Classificato Equiparato Sacro Cuore IT Italy (IT) Vrije Universiteit Amsterdam (VU) / University Amsterdam NL Netherlands (NL) Università degli studi "La Sapienza" IT Italy (IT) Université de Lausanne (UNIL) CH Switzerland (CH) University of Turin / Università degli Studi di Torino (UNITO) IT Italy (IT) St James's University Hospital GB United Kingdom (GB) Paul Scherrer Institute (PSI) CH Switzerland (CH) Universitätsklinikum Freiburg DE Germany (DE)

How to cite

APA:

Niyazi, M., Brada, M., Chalmers, A.J., Combs, S.E., Erridge, S.C., Fiorentino, A.,... Belka, C. (2016). ESTRO-ACROP guideline "target delineation of glioblastomas". Radiotherapy and Oncology, 118(1), 35-42. https://doi.org/10.1016/j.radonc.2015.12.003

MLA:

Niyazi, Maximilian, et al. "ESTRO-ACROP guideline "target delineation of glioblastomas"." Radiotherapy and Oncology 118.1 (2016): 35-42.

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