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Radiation Oncology • Neuro-Oncology
What margins do you use for hypofractionated treatment of glioblastoma?
The margins vary widely in the literature (Roa et al utilized edema +2cm while Perry et al utilized T1+C +1.5cm for CTV).
Answer from: Radiation Oncologist at Academic Institution
Since I am generally using hypofractionated treatment in elderly, unresectable, or poor performance status patients, I tend to favor smaller margins to minimize the risk of toxicity. The largest I would use is edema +1cm for a small tumor with minimal edema. For a large tumor with extensive edema, I...
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Answer from: Radiation Oncologist at Academic Institution
There isn’t much data to guide us regarding which margins are appropriate in this scenario. You certainly could follow the margins used in the trials you listed. As a field, though, we are heading towards smaller CTV margins (for conventionally fractionated) GBM. So I contour T2 FLAIR changes ...
Answer from: Radiation Oncologist at Academic Institution
We retreat GBMs along several lines, and the margins depend on strategy and technique.
1. Small recurrence treated with GKRS as a surrogate for resection:
a. Single session 17Gy - no margin - enhancement only - local control rate 75% retreat as needed.
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