Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Glioblastoma (GBM) is a high grade glioma (brain tumor) that is treated with surgery or biopsy followed by radiotherapy (RT) given daily over 3 or 6 weeks with or without an oral chemotherapy. Radiation is targeted to the visible residual tumor on magnetic resonance imaging (MRI) images plus a large margin of 15 to 30 mm to account for possible cancer cells outside the visible tumor and for potential growth or shifts in tumor position throughout the prolonged RT course. Standard RT uses MRI to create a reference plan (with large margins) and treats that same volume every day. This exposes a large amount of healthy brain tissue to radiation leading to toxicity and reduced quality of life.
A new technology, the MR-Linac, combines an MRI scanner and a Linac (radiation delivery machine) into one unit. This allows for "adaptive" RT by obtaining an updated MRI scan each day just prior to treatment, adapting the RT plan to take into account any changes in the tumor or the patient's anatomy on that given day. This allows for a smaller (5 mm) margin on the visible tumor as its position can be tracked daily. The goal of this study is to use adaptive RT with small margins to demonstrate that the local control of the visible tumor is not compromised compared to the large volumes used with standard non-adaptive RT, while determining whether smaller margins lead to decreased radiation toxicity and therefore improved quality of life by minimizing radiation exposure.
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Reduced margin adaptive radiotherapy | Radiation | Reduced (5 mm) clinical target volume margin with weekly contrast-enhanced adaptive radiation on the MR-Linac treatment machine |
| Measure | Description | Time Frame |
|---|---|---|
| Imaging-detected tumor recurrence at the edge of the radiation volume ("marginal" failure) | The presence of tumor on contrast-enhanced MRI between 1-2 cm from the edge of the treated radiation volume (commonly known as a marginal failure) within 1 year from radiation. | Within 1 year from end of radiation |
| Measure | Description | Time Frame |
|---|---|---|
| Tumor volume changes during RT | Change in gross tumor volume (%) from start to end of RT | 6 weeks |
| Acute radiation toxicity based on RTOG/EORTC Common Toxicity Criteria | Grades 1-4 toxicity during RT in the following categories: skin, CNS, eye, ear, and hematological |
Not provided
Inclusion Criteria:
Exclusion Criteria:
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Sunnybrook Health Sciences Centre | Toronto | Ontario | M4N3M5 | Canada |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 42134380 | Derived | Detsky JS, Chan AW, Moore-Palhares D, Safavi AH, Perry J, Fat MJL, Atenafu EG, Das S, Lipsman N, Heyn C, Maralani P, Czarnota GJ, Ruschin M, Keller B, Lau A, Chen H, Myrehaug SD, Soliman H, Tseng CL, Sahgal A. MRI-guided adaptive radiotherapy for high grade glioma (UNITED): a single-centre, single-arm, non-inferiority, phase 2 trial. Lancet Oncol. 2026 Jun;27(6):729-737. doi: 10.1016/S1470-2045(26)00088-4. Epub 2026 May 14. | |
| 37640160 |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| ID | Term |
|---|---|
| D005909 | Glioblastoma |
| ID | Term |
|---|---|
| D001254 | Astrocytoma |
| D005910 | Glioma |
| D018302 | Neoplasms, Neuroepithelial |
| D017599 | Neuroectodermal Tumors |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| 6 weeks |
| Quality of life changes based on EORTC QLQ-C30 | Changes in quality of life during and after RT based on accepted EORTC cancer quality of life instruments administered each week on RT, 1 month post RT, and every 3 months subsequently | 1 year |
| Dexamethasone usage | Amount of dexamethasone required during RT | 10 weeks |
| Quality of life based on EORTC QLQ-BN20 | Changes in quality of life during and after RT based on accepted EORTC brain tumor quality of life instruments administered each week on RT, 1 month post RT, and every 3 months subsequently | 1 year |
| Derived |
| Lawrence LSP, Chan RW, Chen H, Stewart J, Ruschin M, Theriault A, Myrehaug S, Detsky J, Maralani PJ, Tseng CL, Soliman H, Jane Lim-Fat M, Das S, Stanisz GJ, Sahgal A, Lau AZ. Diffusion-weighted imaging on an MRI-linear accelerator to identify adversely prognostic tumour regions in glioblastoma during chemoradiation. Radiother Oncol. 2023 Nov;188:109873. doi: 10.1016/j.radonc.2023.109873. Epub 2023 Aug 26. |
| D009373 |
| Neoplasms, Germ Cell and Embryonal |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D009375 | Neoplasms, Glandular and Epithelial |
| D009380 | Neoplasms, Nerve Tissue |