What dose and expansion of GTV is recommended for a low grade glioma?
In a large unresectable grade 2 astrocytoma of the temporal lobe, what dose and GTV margin should be used?
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What is your preferred dose/fractionation for low-grade glioma?
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Radiation Oncology · Quint Cities Radiation Oncology
Answered on
I think doses between 45-54 Gy are probably reasonable for low grade gliomas when electing to treat with RT. Several studies have not shown a benefit with dose escalation in the treatment of low grade gliomas (EORTC 45 Gy vs 59.4 Gy; Intergroup 50.4 Gy vs 64.8 Gy).
In terms of treatment volumes, RTOG 98-02 used GTV + 2 cm margin to the block edge. A more current protocol (ECOG E3F05) used T2 or FLAIR sequences to define the GTV. CTV= GTV + 1 cm followed by a PTV expansion. All of this probably ends up treating a very similar volume to RTOG 98-02.