Year: 2023
Type: article
Abstract: The SPECTRO GLIO study is the first randomized trial exploring use of a quantitative imaging modality to guide high-dose (HD) radiation therapy (RT) (72 Gy in 30 fractions) for newly diagnosed glioblastoma (GBM).1 Dr. Laprie et al. deserve congratulations on successfully completing this trial. Their ability to harmonize magnetic resonance spectroscopic imaging (MRSI) among 8 institutions for this trial should be applauded and can serve as a future blueprint for how to perform trials that utilize advanced imaging as an integral component. While RT dose escalation for GBMs has been extensively evaluated including most recently with the NRG-BN001 trial,2 it has been largely ineffective to date. Because previous dose escalation studies only used standard MRIs to define the HD target, all regions at high risk for tumor recurrence that could potentially benefit from dose intensification may not have been identified. The premise for the SPECTRO GLIO trial is that sites with elevated Cho/NAA values (specifically, Cho/NAA > 2) on MRSI may identify these additional at-risk regions resulting in better targeting of HD RT. However, despite “improved” targeting, we are disappointed that this current dose escalation approach again did not show significant clinical benefit with a median overall survival (OS) of 22.2 months in the HD RT cohort versus 22.6 months in the control cohort.
Source: Neuro-Oncology
Authors: Hui-Kuo G Shu, Hyunsuk Shim
Institutions: Emory University, Winship Cancer Institute
Language: English
Subfield: Genetics
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funder: National Cancer Institute
Awards: G197274970, G2075377858
OpenAlex ID: W4386505264