{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T13:12:53Z","timestamp":1760015573447,"version":"3.40.3"},"reference-count":41,"publisher":"Korean Society for Therapeutic Radiology and Oncology","issue":"1","license":[{"start":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T00:00:00Z","timestamp":1734566400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":["e-roj.org"],"crossmark-restriction":true},"short-container-title":["Radiat Oncol J"],"published-print":{"date-parts":[[2025,3,31]]},"abstract":"<jats:p>Purpose: No guidelines exist to delineate radiation therapy (RT) targets for the treatment of multiple glioblastoma (mGBM). This study analyzes margins around the gross tumor volume (GTV) to create a clinical target volume (CTV), comparing response parameters and modalities of recurrence.Material and Methods: One-hundred and three mGBM patients with a CTV margin of 2 cm (GTV + 2.0 cm) or 1 cm (GTV + 1.0 cm) were retrospectively analyzed. All patients received a total dose of 59.4\u201360 Gy in 1.8-2.0 Gy daily fractions, delivered from 4 to 8 weeks after surgery, concomitantly with temozolomide (75 mg\/m2). Overall survival (OS) and progression-free survival (PFS) were calculated from the date of surgery until diagnosis of disease progression performed by magnetic resonance imaging and classified as marginal, in-field, or distant, comparing site of progression with dose distribution in RT plan.Results: OS in mGBM CTV1 group was 11.2 months (95% confidence interval [CI], 10.3\u201312.1), and 9.2 months in mGBM CTV2 group (95% CI, 9.0\u201311.3). PFS in mGBM CTV1 group occurred within 8.3 months (95% CI, 7.3\u20139.3), and 7.3 months in mGBM CTV2 group (95% CI, 6.4\u20138.1). No difference was observed between the two groups in terms of OS and PFS time distribution. Adjusted to a multivariate Cox risk model, epidermal growth factor receptor amplification resulted a negative prognostic factor for both OS and PFS.Conclusion: In mGBM, the use of a 1 cm CTV expansion seems feasible as it does not significantly affect oncological outcomes and progression outcome.<\/jats:p>","DOI":"10.3857\/roj.2024.00059","type":"journal-article","created":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T04:27:47Z","timestamp":1734582467000},"page":"13-21","update-policy":"https:\/\/doi.org\/10.3857\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Reducing clinical target volume margins for multifocal glioblastoma: a multi-institutional analysis of patterns of recurrence and treatment response"],"prefix":"10.3857","volume":"43","author":[{"given":"Francesco","family":"Marampon","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni 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