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Radiation Oncology • Neuro-Oncology
In light of recent WHO classification update for glioma, how would your treatment volumes and dose prescription change for a non-enhancing molecular glioblastoma?
With the recent WHO classification redefining IDHwt tumors as glioblastoma, more patients have imaging features that are historically consistent with low-grade glioma. Would you treat surgical cavity plus residual T2 flair signal with margin to 60Gy, similar to volumes for low grade glioma? Or would you cone down from T2 flair to treat the surgical cavity where there was a more clearly defined mass similar to RTOG/NRG guidelines for glioblastoma?
Answer from: Radiation Oncologist at Community Practice
I would argue that the CTV for a molecularly defined IDH-wt tumor without radiographic hallmarks of contrast enhancement should be considered differently than for those of a more "classic" radiographic/histologic GBM (i.e., with mitoses, endothelial proliferation, atypia, necrosis). It's a different...
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