1.Reducing clinical target volume margins for multifocal glioblastoma: a multi-institutional analysis of patterns of recurrence and treatment response
Francesco MARAMPON ; Giovanni Luca GRAVINA ; Elisa CINELLI ; Lucy ZACCARO ; Miriam TOMACIELLO ; Nunzia Di MEGLIO ; Francesco GENTILI ; Alfonso CERASE ; Armando PERRELLA ; Mariya YAVORSKA ; Sami ABURAS ; Luciano MUTTI ; Maria Antonietta MAZZEI ; Giuseppe MINNITI ; Paolo TINI
Radiation Oncology Journal 2025;43(1):13-21
Purpose:
No guidelines exist to delineate radiation therapy (RT) targets for the treatment of multiple glioblastoma (mGBM). This study analyzes margins around the gross tumor volume (GTV) to create a clinical target volume (CTV), comparing response parameters and modalities of recurrence.Material and Methods: One-hundred and three mGBM patients with a CTV margin of 2 cm (GTV + 2.0 cm) or 1 cm (GTV + 1.0 cm) were retrospectively analyzed. All patients received a total dose of 59.4–60 Gy in 1.8-2.0 Gy daily fractions, delivered from 4 to 8 weeks after surgery, concomitantly with temozolomide (75 mg/m2). Overall survival (OS) and progression-free survival (PFS) were calculated from the date of surgery until diagnosis of disease progression performed by magnetic resonance imaging and classified as marginal, in-field, or distant, comparing site of progression with dose distribution in RT plan.
Results:
OS in mGBM CTV1 group was 11.2 months (95% confidence interval [CI], 10.3–12.1), and 9.2 months in mGBM CTV2 group (95% CI, 9.0–11.3). PFS in mGBM CTV1 group occurred within 8.3 months (95% CI, 7.3–9.3), and 7.3 months in mGBM CTV2 group (95% CI, 6.4–8.1). No difference was observed between the two groups in terms of OS and PFS time distribution. Adjusted to a multivariate Cox risk model, epidermal growth factor receptor amplification resulted a negative prognostic factor for both OS and PFS.
Conclusion
In mGBM, the use of a 1 cm CTV expansion seems feasible as it does not significantly affect oncological outcomes and progression outcome.
2.Reducing clinical target volume margins for multifocal glioblastoma: a multi-institutional analysis of patterns of recurrence and treatment response
Francesco MARAMPON ; Giovanni Luca GRAVINA ; Elisa CINELLI ; Lucy ZACCARO ; Miriam TOMACIELLO ; Nunzia Di MEGLIO ; Francesco GENTILI ; Alfonso CERASE ; Armando PERRELLA ; Mariya YAVORSKA ; Sami ABURAS ; Luciano MUTTI ; Maria Antonietta MAZZEI ; Giuseppe MINNITI ; Paolo TINI
Radiation Oncology Journal 2025;43(1):13-21
Purpose:
No guidelines exist to delineate radiation therapy (RT) targets for the treatment of multiple glioblastoma (mGBM). This study analyzes margins around the gross tumor volume (GTV) to create a clinical target volume (CTV), comparing response parameters and modalities of recurrence.Material and Methods: One-hundred and three mGBM patients with a CTV margin of 2 cm (GTV + 2.0 cm) or 1 cm (GTV + 1.0 cm) were retrospectively analyzed. All patients received a total dose of 59.4–60 Gy in 1.8-2.0 Gy daily fractions, delivered from 4 to 8 weeks after surgery, concomitantly with temozolomide (75 mg/m2). Overall survival (OS) and progression-free survival (PFS) were calculated from the date of surgery until diagnosis of disease progression performed by magnetic resonance imaging and classified as marginal, in-field, or distant, comparing site of progression with dose distribution in RT plan.
Results:
OS in mGBM CTV1 group was 11.2 months (95% confidence interval [CI], 10.3–12.1), and 9.2 months in mGBM CTV2 group (95% CI, 9.0–11.3). PFS in mGBM CTV1 group occurred within 8.3 months (95% CI, 7.3–9.3), and 7.3 months in mGBM CTV2 group (95% CI, 6.4–8.1). No difference was observed between the two groups in terms of OS and PFS time distribution. Adjusted to a multivariate Cox risk model, epidermal growth factor receptor amplification resulted a negative prognostic factor for both OS and PFS.
Conclusion
In mGBM, the use of a 1 cm CTV expansion seems feasible as it does not significantly affect oncological outcomes and progression outcome.
3.Reducing clinical target volume margins for multifocal glioblastoma: a multi-institutional analysis of patterns of recurrence and treatment response
Francesco MARAMPON ; Giovanni Luca GRAVINA ; Elisa CINELLI ; Lucy ZACCARO ; Miriam TOMACIELLO ; Nunzia Di MEGLIO ; Francesco GENTILI ; Alfonso CERASE ; Armando PERRELLA ; Mariya YAVORSKA ; Sami ABURAS ; Luciano MUTTI ; Maria Antonietta MAZZEI ; Giuseppe MINNITI ; Paolo TINI
Radiation Oncology Journal 2025;43(1):13-21
Purpose:
No guidelines exist to delineate radiation therapy (RT) targets for the treatment of multiple glioblastoma (mGBM). This study analyzes margins around the gross tumor volume (GTV) to create a clinical target volume (CTV), comparing response parameters and modalities of recurrence.Material and Methods: One-hundred and three mGBM patients with a CTV margin of 2 cm (GTV + 2.0 cm) or 1 cm (GTV + 1.0 cm) were retrospectively analyzed. All patients received a total dose of 59.4–60 Gy in 1.8-2.0 Gy daily fractions, delivered from 4 to 8 weeks after surgery, concomitantly with temozolomide (75 mg/m2). Overall survival (OS) and progression-free survival (PFS) were calculated from the date of surgery until diagnosis of disease progression performed by magnetic resonance imaging and classified as marginal, in-field, or distant, comparing site of progression with dose distribution in RT plan.
Results:
OS in mGBM CTV1 group was 11.2 months (95% confidence interval [CI], 10.3–12.1), and 9.2 months in mGBM CTV2 group (95% CI, 9.0–11.3). PFS in mGBM CTV1 group occurred within 8.3 months (95% CI, 7.3–9.3), and 7.3 months in mGBM CTV2 group (95% CI, 6.4–8.1). No difference was observed between the two groups in terms of OS and PFS time distribution. Adjusted to a multivariate Cox risk model, epidermal growth factor receptor amplification resulted a negative prognostic factor for both OS and PFS.
Conclusion
In mGBM, the use of a 1 cm CTV expansion seems feasible as it does not significantly affect oncological outcomes and progression outcome.
4.Reducing clinical target volume margins for multifocal glioblastoma: a multi-institutional analysis of patterns of recurrence and treatment response
Francesco MARAMPON ; Giovanni Luca GRAVINA ; Elisa CINELLI ; Lucy ZACCARO ; Miriam TOMACIELLO ; Nunzia Di MEGLIO ; Francesco GENTILI ; Alfonso CERASE ; Armando PERRELLA ; Mariya YAVORSKA ; Sami ABURAS ; Luciano MUTTI ; Maria Antonietta MAZZEI ; Giuseppe MINNITI ; Paolo TINI
Radiation Oncology Journal 2025;43(1):13-21
Purpose:
No guidelines exist to delineate radiation therapy (RT) targets for the treatment of multiple glioblastoma (mGBM). This study analyzes margins around the gross tumor volume (GTV) to create a clinical target volume (CTV), comparing response parameters and modalities of recurrence.Material and Methods: One-hundred and three mGBM patients with a CTV margin of 2 cm (GTV + 2.0 cm) or 1 cm (GTV + 1.0 cm) were retrospectively analyzed. All patients received a total dose of 59.4–60 Gy in 1.8-2.0 Gy daily fractions, delivered from 4 to 8 weeks after surgery, concomitantly with temozolomide (75 mg/m2). Overall survival (OS) and progression-free survival (PFS) were calculated from the date of surgery until diagnosis of disease progression performed by magnetic resonance imaging and classified as marginal, in-field, or distant, comparing site of progression with dose distribution in RT plan.
Results:
OS in mGBM CTV1 group was 11.2 months (95% confidence interval [CI], 10.3–12.1), and 9.2 months in mGBM CTV2 group (95% CI, 9.0–11.3). PFS in mGBM CTV1 group occurred within 8.3 months (95% CI, 7.3–9.3), and 7.3 months in mGBM CTV2 group (95% CI, 6.4–8.1). No difference was observed between the two groups in terms of OS and PFS time distribution. Adjusted to a multivariate Cox risk model, epidermal growth factor receptor amplification resulted a negative prognostic factor for both OS and PFS.
Conclusion
In mGBM, the use of a 1 cm CTV expansion seems feasible as it does not significantly affect oncological outcomes and progression outcome.
5.Reducing clinical target volume margins for multifocal glioblastoma: a multi-institutional analysis of patterns of recurrence and treatment response
Francesco MARAMPON ; Giovanni Luca GRAVINA ; Elisa CINELLI ; Lucy ZACCARO ; Miriam TOMACIELLO ; Nunzia Di MEGLIO ; Francesco GENTILI ; Alfonso CERASE ; Armando PERRELLA ; Mariya YAVORSKA ; Sami ABURAS ; Luciano MUTTI ; Maria Antonietta MAZZEI ; Giuseppe MINNITI ; Paolo TINI
Radiation Oncology Journal 2025;43(1):13-21
Purpose:
No guidelines exist to delineate radiation therapy (RT) targets for the treatment of multiple glioblastoma (mGBM). This study analyzes margins around the gross tumor volume (GTV) to create a clinical target volume (CTV), comparing response parameters and modalities of recurrence.Material and Methods: One-hundred and three mGBM patients with a CTV margin of 2 cm (GTV + 2.0 cm) or 1 cm (GTV + 1.0 cm) were retrospectively analyzed. All patients received a total dose of 59.4–60 Gy in 1.8-2.0 Gy daily fractions, delivered from 4 to 8 weeks after surgery, concomitantly with temozolomide (75 mg/m2). Overall survival (OS) and progression-free survival (PFS) were calculated from the date of surgery until diagnosis of disease progression performed by magnetic resonance imaging and classified as marginal, in-field, or distant, comparing site of progression with dose distribution in RT plan.
Results:
OS in mGBM CTV1 group was 11.2 months (95% confidence interval [CI], 10.3–12.1), and 9.2 months in mGBM CTV2 group (95% CI, 9.0–11.3). PFS in mGBM CTV1 group occurred within 8.3 months (95% CI, 7.3–9.3), and 7.3 months in mGBM CTV2 group (95% CI, 6.4–8.1). No difference was observed between the two groups in terms of OS and PFS time distribution. Adjusted to a multivariate Cox risk model, epidermal growth factor receptor amplification resulted a negative prognostic factor for both OS and PFS.
Conclusion
In mGBM, the use of a 1 cm CTV expansion seems feasible as it does not significantly affect oncological outcomes and progression outcome.