Authors
Shuangshuang He, Hang Yu, Yuan Yang, Qing Mao, Xiang Wang, Yunhui Zeng, Feng Wang, Mengyuan Liu, Yuantai Li, Kun Gao, Xingchen Peng, Yanhui Liu, Ping Ai
Published in
Cancer medicine. Volume 15. Issue 9. Pages e72225.
Abstract
Currently, there is no clear guidance on the appropriate population or timing for adaptive radiotherapy (ART) in high-grade glioma (HGG) patients. This study aims to provide individualized ART for HGG patients.
Participants received standard "radiotherapy combined with temozolomide" and underwent MRI before radiotherapy (FX0), after fraction 10 (FX10), and after fraction 20 (FX20). The primary endpoint was anatomical and dosimetric changes in targets and organs at risk (OARs).
Among the 73 eligible patients, significant anatomical changes occurred during chemoradiotherapy, particularly at FX10. ART significantly improved target dose coverage and reduced OAR doses compared with projection plans. Univariable and multivariable logistic regression analysis identified Relative volume change (Vrel)_CTV ≥ 7% as an independent risk factor for dosimetric changes, with IDH wild-type and tumor diameters < 5 cm as independent risk factors. Median follow-up was 12 months; median progression-free survival (PFS) was 18 months. D_migration_max_CTV ≥ 8.5 mm was associated with worse PFS.
Implementing ART after FX10 is recommended. HGG patients with wild-type IDH and tumor diameters < 5 cm should be prioritized for ART. Patients with D_migration_max_CTV ≥ 8.5 mm require more intensive treatment.
The trial was prospectively registered (ClinicalTrials.gov, NCT06201351).
PMID:
42675793
Bibliographic data and abstract were imported from PubMed on 01 Sep 2026.
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