Spatial patterns of glioblastoma failure related to contouring strategy of adjuvant radiotherapy (RTOG vs. EORTC target volumes approach): clinical trial introduction

Czech version

Authors: R. Hejnová ¹; A. Holešovská ¹; P. Pospíšil ^2,3; R. Lakomý ^4,5; L. Hynková ^2,3; I. Selingerová ⁶; R. Belanová ^7,8; M. Standara ⁷; R. Jančálek ^9,10; M. Smrčka ¹¹; P. Fadrus ¹¹; K. Múčková ¹²; M. Hendrych ¹³; T. Chodúr ¹⁴; K. Šiff Elová ¹⁴; J. Šána ^4,5,12; T. Prochazka ²; O. Slabý ^4,5,12; P. Šlampa ^2,3; T. Kazda ^2,3,6
Authors‘ workplace: Oddělení klinických hodnocení, MOÚ, Brno ¹; Klinika radiační onkologie MOÚ, Brno ²; Klinika radiační onkologie LF MU, Brno ³; Klinika komplexní onkologické péče MOÚ, Brno ⁴; Klinika komplexní onkologické péče LF MU, Brno ⁵; Výzkumné centrum aplikované molekulární onkologie (RECAMO), MOÚ, Brno ⁶; Oddělení radiologie, MOÚ, Brno ⁷; LF MU, Brno ⁸; Neurochirurgická klinika FN u sv. Anny v Brně ⁹; Neurochirurgická klinika LF MU a FN U sv. Anny v Brně ¹⁰; Neurochirurgická klinika, LF MU a FN Brno ¹¹; Ústav patologie LF MU a FN Brno ¹²; I. ústav patologie LF MU a FN u sv. Anny v Brně ¹³; Úsek klinické psychologie, MOÚ, Brno ¹⁴
Published in: Klin Onkol 2020; 33(Suppl 1): 20-26
Category: Review
doi: https://doi.org/10.14735/amko2020S20

Overview

Background: Glioblastoma represents the most common and the most aggressive primary brain tumor in adults. Radiotherapy is indicated in almost all patients suffering with this disease. The importance of valid contouring (target volume definition) in radiotherapy of glioblastomas is currently increasing. The two basic contouring approaches in glioblastoma are the „American“ approach of the Radiation Therapy Oncology Group (RTOG contouring approach defining two target volumes) and the „European“ approach of the European Organization for Research and Treatment of Cancer (EORTC contouring approach with one target volume). Both mentioned approaches are considered standard of radiotherapy care. In daily radiotherapy practice, a specific contouring procedure is often chosen also according to the convention and tradition of the pertinent workplace. An important parameter in assessing the approach to contouring in radiotherapy is the evaluation of patterns of failure (PoF, spatial evaluation of subsequent relapses).

Purpose: The GlioART, academic investigator initiated clinical study, compares the RTOG and EORTC approaches in a prospective setup, taking into account all parameters necessary for valid evaluation of progressions – definition of relapses, MR specification demonstrating progression, planned radiotherapy technique, glioblastoma molecular biological characteristics, resection extent and localization of the original glioblastoma. The aim of this paper is to present the GlioART study and to discuss the associated topics associated with defining the target volumes in radiotherapy.

Conclusion: The results of the GlioART trial may define recommendations influencing daily clinical practice in glioblastoma radiotherapy.

Keywords:

radiotherapy – glioblastoma – contouring – patterns of failure – GlioART

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