Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Apr 21;20(3):506-513.
doi: 10.1055/s-0045-1807761. eCollection 2025 Sep.

Comparison of Quality of Life in Postoperative High-Grade Glioma Patients Treated Using EORTC and RTOG Target Delineation Techniques for Postoperative Radiotherapy

Shreyosi Mandal  1   2 , Deepa Joseph  1 , Ajay Krishnan  1   3 , Pragya Singh  1   4 , Rajnish Kumar Arora  5 , Udit Chauhan  6 , Sweety Gupta  1 , Lekshmi R  1 , Manoj Gupta  1
Affiliations

Comparison of Quality of Life in Postoperative High-Grade Glioma Patients Treated Using EORTC and RTOG Target Delineation Techniques for Postoperative Radiotherapy

Shreyosi Mandal et al. Asian J Neurosurg. .

Abstract

Introduction: High-grade gliomas (HGGs) have dismal prognosis even with multimodality treatment entailing surgery, radiotherapy, and chemotherapy. Hence, assessment of improvement in quality of life (QOL) for evaluating treatment is critical. Target delineation for radiotherapy in HGG is often done according to the European Organization for Research and Treatment of Cancer (EORTC) and Radiotherapy and Oncology Group (RTOG) contouring guidelines, which differs on exclusion and inclusion of peritumoral edema believed to harbor malignant cells; the guidelines have not been prospectively compared for probable difference in QOL, considering the probable difference in treated volume.

Objective: This article compares QOL in HGG patients receiving postoperative radiotherapy using target volume delineation based on the RTOG or EORTC guidelines.

Materials and methods: In this single-center, prospective randomized exploratory study, postoperative HGG patients were randomized to either receive radiotherapy according to the EORTC guidelines of target delineation (60 Gy/30 fractions to tumor bed and residual tumor) or the RTOG guidelines (46 Gy/23fractions to tumor bed, residual tumor, and peritumoral edema with 14 Gy/7 fraction boost to the tumor bed and residual tumor) with concurrent temozolomide (TMZ) followed by 6 months of adjuvant TMZ. The aim and primary endpoint of the study was to assess and compare QOL between the arms. Descriptive statistics were used to convey demographic data, proportions for categorical variables, and mean, median, range, and standard deviation for continuous variables. Effect size was assessed using partial eta squared test where values of 0.01, 0.06, and 0.14 signify small, medium, and large effect size, respectively. Repeated measures analysis of variance test was used for comparison of means and assessment of QOL between the EORTC and RTOG groups at 6 months. Absolute volume of planning target volume (PTV) receiving 46 and 60 Gy were described, PTV 46/60 was also described in terms of % of whole brain volume.

Results: Eighteen patients underwent randomization (9 in EORTC and RTOG group each). Statistically significant improvement was noted in the overall posttreatment values in the physical well-being (PWB) domain ( p = 0.007).

Conclusion: This is the first study to compare the EORTC and RTOG delineation techniques in terms of QOL. No significant differences in QOL were noted between the two arms. Significant improvement was noted posttreatment in PWB of overall patients.

Keywords: FACT-Br; brain; glioma; high-grade; neurocognitive functions; quality of life; radiotherapy.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest None declared.

Figures

Fig. 1
Fig. 1
Consort diagram.
Fig. 2
Fig. 2
( A – D ) Comparison of quality of life (QOL) at baseline vs. 6 months European Organization for Research and Treatment of Cancer (EORTC) vs. Radiotherapy and Oncology Group (RTOG).
Fig. 3
Fig. 3
( A – D ) Comparison of quality of life (QOL) at baseline vs. 6 months European Organization for Research and Treatment of Cancer (EORTC) vs. Radiotherapy and Oncology Group (RTOG).
See this image and copyright information in PMC

References

    1. 31-Brain-central-nervous-system-fact-sheet.pdf. Accessed April 2, 2025 at:https://gco.iarc.fr/today/data/factsheets/cancers/31-Brain-central-nervo...
    1. Dong X, Noorbakhsh A, Hirshman B R et al. Survival trends of grade I, II, and III astrocytoma patients and associated clinical practice patterns between 1999 and 2010: a SEER-based analysis. Neurooncol Pract. 2016;3(01):29–38. - PMC - PubMed
    1. Shin D W, Lee S, Song S W et al. Survival outcome and prognostic factors in anaplastic oligodendroglioma: a single-institution study of 95 cases. Sci Rep. 2020;10(01):20162. - PMC - PubMed
    1. Kristiansen K, Hagen S, Kollevold T et al. Combined modality therapy of operated astrocytomas grade III and IV. Confirmation of the value of postoperative irradiation and lack of potentiation of bleomycin on survival time: a prospective multicenter trial of the Scandinavian Glioblastoma Study Group. Cancer. 1981;47(04):649–652. - PubMed
    1. Niyazi M, Brada M, Chalmers A J et al. ESTRO-ACROP guideline “target delineation of glioblastomas.”. Radiother Oncol. 2016;118(01):35–42. - PubMed

LinkOut - more resources