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
 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 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 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





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
This is a Figure Slide
Thank You