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This is Your Title Slide With Two Lines of Text. Principal Author, MD Second Author, MD PhD Third Author, MSc Institution, City, Country 23 January 2013. Text Slide. Glioblastoma Multiforme (GBM) is the most common primary brain malignant neoplasm in adults

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this is your title slide with two lines of text

This is Your Title SlideWith Two Lines of Text

Principal Author, MD

Second Author, MD PhD

Third Author, MSc

Institution, City, Country

23 January 2013

text slide
Text Slide
  • Glioblastoma Multiforme (GBM) is the most common primary brain malignant neoplasm in adults
  • Despite constant attempts to improve outcome, the survival of patients with GBM remains limited
  • Currently, the standard of care consists of maximal safe surgical resection followed by External Beam Radiotherapy (EBRT) and concomitant TMZ followed by adjuvant TMZ
text slide1
Text Slide
  • Post-operative EBRT:
    • 60 Gy/30 daily fractions over 6 weeks
    • PTV margins extending to 2 to 2.5 cm from oedema/residual disease and surgical cavity
  • Dose response curve
    • Souhami, L. et al, 2004.
      • RTOG 9305 for SRS boost in addition to conventional EBRT
    • Laperrière, N. et al, 1998.
      • Interstitial Implant in addition to conventional EBRT
text slide2
Text Slide
  • IMRT
    • Concomitant boost technique
      • Shorten overall treatment time: reduces accelerated repopulation
      • Larger dose/fraction: increases cell killing
    • MRI co-registration
  • Immobilization
  • Treatment delivery verification
    • IGRT
    • Limited margins: reduce the normal brain volume irradiated
    • Reduction of treatment-related toxicity
schema
Schema
  • Temozolomide ¢ XRT+Temozolomide ¢ Temozolomide
  • Neo-adjuvant TMZ: 75 mg/m² QD will be administered for 2 weeks before starting radiotherapy
  • Accelerated Radiotherapy: 60 Gy in 20 fractions over 4 weeks using IMRT concomitant boost technique
  • Concurrent TMZ with accelerated hypofractionated radiotherapy: 75 mg/m² QD for the whole duration of radiotherapy
  • Adjuvant TMZ: 150 mg/m² QD for 5 consecutive days of a 28 day-cycle