Back to Search Start Over

ESTRO-EANO guideline on target delineation and radiotherapy for IDHmutant WHO CNS grade 2 and 3 diffuse glioma.

Authors :
Baumert BG
P M Jaspers J
Keil VC
Galldiks N
Izycka-Swieszewska E
Timmermann B
Grosu AL
Minniti G
Ricardi U
Dhermain F
Weber DC
van den Bent M
Rudà R
Niyazi M
Erridge S
Source :
Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology [Radiother Oncol] 2024 Oct 23, pp. 110594. Date of Electronic Publication: 2024 Oct 23.
Publication Year :
2024
Publisher :
Ahead of Print

Abstract

Purpose: This guideline will discuss radiotherapeutic management of IDH mutant grade 2 and grade 3 diffuse glioma, using the latest 2021 WHO (5th) classification of brain tumours focusing on: imaging modalities, tumour volume delineation, irradiation dose and fractionation.<br />Methods: The ESTRO Guidelines Committee, CNS subgroup, nominated 15 European experts who identified questions for this guideline. Four working groups were established addressing specific questions concerning imaging, target volume delineation, radiation techniques and fractionation. A literature search was performed, and available literature was discussed. A modified two-step Delphi process was used with majority voting resulted in a decision or highlighting areas of uncertainty.<br />Results: Key issues identified and discussed included imaging needed to define target definition, target delineation and the size of margins, and technical aspects of treatment including different planning techniques such as proton therapy.<br />Conclusions: The GTV should include any residual tumour volume after surgery, as well as the resection cavity. Enhancing lesions on T1 imaging should be included if they are indicative of residual tumour. In grade 2 tumours, T2/FLAIR abnormalities should be included in the GTV. In grade 3 tumours, T2/FLAIR abnormalities should also be included, except areas that are considered to be oedema which should be omitted from the GTV. A GTV to CTV expansion of 10 mm is recommended in grade 2 tumours and 15 mm in grade 3 tumours. A treatment dose of 50.4 Gy in 28 fractions is recommended in grade 2 tumours and 59.4 Gy in 33 fractions in grade 3 tumours. Radiation techniques with IMRT are the preferred approach.<br />Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.<br /> (Copyright © 2024. Published by Elsevier B.V.)

Details

Language :
English
ISSN :
1879-0887
Database :
MEDLINE
Journal :
Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
Publication Type :
Academic Journal
Accession number :
39454886
Full Text :
https://doi.org/10.1016/j.radonc.2024.110594