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ESTRO-EANO guideline on target delineation and radiotherapy details for glioblastoma

Niyazi, Maximilian ; Andratschke, Nicolaus ; Bendszus, Martin ; Chalmers, Anthony J. ; Erridge, Sara C. ; Galldiks, Norbert ; Lagerwaard, Frank J. ; Navarria, Pierina ; Munck af Rosenschöld, Per LU orcid and Ricardi, Umberto , et al. (2023) In Radiotherapy and Oncology 184.
Abstract

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... (More)

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.

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type
Contribution to journal
publication status
published
subject
keywords
Delineation, EANO, ESTRO, Glioblastoma, Radiotherapy, Target volume
in
Radiotherapy and Oncology
volume
184
article number
109663
publisher
Elsevier
external identifiers
  • pmid:37059335
  • scopus:85153030506
ISSN
0167-8140
DOI
10.1016/j.radonc.2023.109663
language
English
LU publication?
yes
id
02f945e5-f4d9-484e-8cf0-6c35d9535ead
date added to LUP
2023-06-12 15:23:32
date last changed
2024-04-19 22:47:32
@article{02f945e5-f4d9-484e-8cf0-6c35d9535ead,
  abstract     = {{<p>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.</p>}},
  author       = {{Niyazi, Maximilian and Andratschke, Nicolaus and Bendszus, Martin and Chalmers, Anthony J. and Erridge, Sara C. and Galldiks, Norbert and Lagerwaard, Frank J. and Navarria, Pierina and Munck af Rosenschöld, Per and Ricardi, Umberto and van den Bent, Martin J. and Weller, Michael and Belka, Claus and Minniti, Giuseppe}},
  issn         = {{0167-8140}},
  keywords     = {{Delineation; EANO; ESTRO; Glioblastoma; Radiotherapy; Target volume}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{Radiotherapy and Oncology}},
  title        = {{ESTRO-EANO guideline on target delineation and radiotherapy details for glioblastoma}},
  url          = {{http://dx.doi.org/10.1016/j.radonc.2023.109663}},
  doi          = {{10.1016/j.radonc.2023.109663}},
  volume       = {{184}},
  year         = {{2023}},
}