, Volume 89, Issue 3, pp 313-337
Date: 20 Aug 2008

Radiation therapy of pathologically confirmed newly diagnosed glioblastoma in adults

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Recommendations

Level 1

Radiation therapy is recommended for the treatment of newly diagnosed malignant glioma in adults. Treatment schemes should include dosage of up to 60 Gy given in 2 Gy daily fractions that includes the enhancing area.

Hypo-fractionated radiation schemes may be used for patients with a poor prognosis and limited survival without compromising response.

Hyper-fractionation and accelerated fractionation have not been shown to be superior to conventional fractionation and are not recommended.

Brachytherapy or stereotactic radiosurgery as a boost to external beam radiotherapy have not been shown to be beneficial and are not recommended in the routine management of newly diagnosed malignant glioma.

Level 2

It is recommended that radiation therapy planning include a 1–2 cm margin around the radiographically defined T1 contrast-enhancing tumor volume or the T2 weighted abnormality on MR imaging.

Rationale

Although radiation therapy has been a standard therapy for the treatment of