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. 2023 May 23:13:1108587.
doi: 10.3389/fonc.2023.1108587. eCollection 2023.

Comparative dosimetric study of radiotherapy in high-grade gliomas based on the guidelines of EORTC and NRG-2019 target delineation

Ouying Yan  1 , Haibo Teng  2 , Cuihong Jiang  1 , Lili He  1 , Shuai Xiao  1 , Yanxian Li  1 , Wenqiong Wu  1 , Qi Zhao  1 , Xu Ye  1 , Wen Liu  1 , Changgen Fan  1 , Xiangwei Wu  1 , Feng Liu  1
Affiliations

Comparative dosimetric study of radiotherapy in high-grade gliomas based on the guidelines of EORTC and NRG-2019 target delineation

Ouying Yan et al. Front Oncol. .

Abstract

Purpose: Radiotherapy is one of the most important treatments for high-grade glioma (HGG), but the best way to delineate the target areas for radiotherapy remains controversial, so our aim was to compare the dosimetric differences in radiation treatment plans generated based on the European Organization for Research and Treatment of Cancer (EORTC) and National Research Group (NRG) consensus to provide evidence for optimal target delineation for HGG.

Methods: We prospectively enrolled 13 patients with a confirmed HGG from our hospital and assessed dosimetric differences in radiotherapy treatment plans generated according to the EORTC and NRG-2019 guidelines. For each patient, two treatment plans were generated. Dosimetric parameters were compared by dose-volume histograms for each plan.

Results: The median volume for planning target volume (PTV) of EORTC plans, PTV1 of NRG-2019 plans, and PTV2 of NRG-2019 plans were 336.6 cm3 (range, 161.1-511.5 cm3), 365.3 cm3 (range, 123.4-535.0 cm3), and 263.2 cm3 (range, 116.8-497.7 cm3), respectively. Both treatment plans were found to have similar efficiency and evaluated as acceptable for patient treatment. Both treatment plans showed well conformal index and homogeneity index and were not statistically significantly different (P = 0.397 and P = 0.427, respectively). There was no significant difference in the volume percent of brain irradiated to 30, 46, and 60 Gy according to different target delineations (P = 0.397, P = 0.590, and P = 0.739, respectively). These two plans also showed no significant differences in the doses to the brain stem, optic chiasm, left and right optic nerves, left and right lens, left and right eyes, pituitary, and left and right temporal lobes (P = 0.858, P = 0.858, P = 0.701 and P = 0.794, P = 0.701 and P = 0.427, P = 0.489 and P = 0.898, P = 0.626, and P = 0.942 and P = 0.161, respectively).

Conclusion: The NRG-2019 project did not increase the dose of organs at risk (OARs) radiation. This is a significant finding that further lays the groundwork for the application of the NRG-2019 consensus in the treatment of patients with HGGs.

Clinical trial registration: The effect of radiotherapy target area and glial fibrillary acidic protein (GFAP) on the prognosis of high-grade glioma and its mechanism, number ChiCTR2100046667. Registered 26 May 2021.

Keywords: OARs; dosimetric; high grade gliomas; radiotherapy; target delineation.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer RW declared a shared parent affiliation with the authors OY, CJ, LH, SX, YL, WW, QZ, XY, WL, CF, XW, FL to the handling editor at the time of review.

Figures

Figure 1
Figure 1
A 57-year-old female patient with postoperative pathology showing glioblastoma (WHO IV, 2016). (A, C) Target area delineation figures: (A) the EORTC delineation method and (C) the NRG-2019 delineation method. (B, D) Schematic illustrations of the planned dose distribution of EORTC and NRG-2019, respectively.
See this image and copyright information in PMC

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