Three-dimensional conformal therapy vs. intensity modulated radiation therapy in GBM: survival, dosimetry, and side effects a systematic review and meta-analysis
BackgroundGlioblastoma multiforme (GBM) is an aggressive brain tumor with a poor prognosis, often managed with radiotherapy. Two primary modalities, three-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT), differ in their precision and impact on survival, side e...
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Frontiers Media S.A.
2025-08-01
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| Series: | Frontiers in Physics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphy.2025.1632620/full |
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| author | Omar Freihat David Sipos Reham Kotb Maria Aamir Dóra Solymosi Kristóf Gál Simon Mihály Arpad Kovacs |
| author_facet | Omar Freihat David Sipos Reham Kotb Maria Aamir Dóra Solymosi Kristóf Gál Simon Mihály Arpad Kovacs |
| author_sort | Omar Freihat |
| collection | DOAJ |
| description | BackgroundGlioblastoma multiforme (GBM) is an aggressive brain tumor with a poor prognosis, often managed with radiotherapy. Two primary modalities, three-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT), differ in their precision and impact on survival, side effects, and OAR sparing. However, their comparative benefits remain unclear. This meta-analysis evaluates 3D-CRT and IMRT in GBM treatment, focusing on dosimetric parameters, toxicity, and OAR sparing, with an exploratory analysis of overall survival (OS).MethodsA systematic review of 19 studies was conducted, comparing dosimetric and side effects, including planning target volume (PTV) doses (Dmean, Dmax, and Dmin), conformity and homogeneity indices, and OAR sparing.ResultsIMRT provided significant dosimetric advantages, with higher PTV Dmean (mean difference (MD) 1.26 Gy; 95% CI: 0.22–2.31; P = 0.02) and better conformity index (MD −0.21; 95% CI: −0.33 to −0.08; P = 0.001). IMRT significantly reduced doses to healthy brain (MD −1.08 Gy; 95% CI: −2.08 to −0.09; P = 0.03), brainstem (MD −0.66 Gy; 95% CI: −1.18 to −0.15; P = 0.01), optic chiasm (MD −4.93 Gy; 95% CI: −9.15 to −0.70; P = 0.02), right optic nerve (MD -5.82 Gy; 95% CI: −9.49 to −2.15; P = 0.002), and left optic nerve (MD −1.20 Gy; 95% CI: −1.77 to −0.63; P < 0.0001).ConclusionIMRT provides significant dosimetric benefits and potentially lower toxicity compared to 3D-CRT in GBM treatment. While an exploratory analysis suggests a possible OS benefit, this requires cautious interpretation due to study limitations. IMRT’s precision supports its use in GBM treatment. |
| format | Article |
| id | doaj-art-c54b23dcc04d4acbbaaa569d5e6f3c65 |
| institution | Kabale University |
| issn | 2296-424X |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Physics |
| spelling | doaj-art-c54b23dcc04d4acbbaaa569d5e6f3c652025-08-20T03:59:40ZengFrontiers Media S.A.Frontiers in Physics2296-424X2025-08-011310.3389/fphy.2025.16326201632620Three-dimensional conformal therapy vs. intensity modulated radiation therapy in GBM: survival, dosimetry, and side effects a systematic review and meta-analysisOmar Freihat0David Sipos1Reham Kotb2Maria Aamir3Dóra Solymosi4Kristóf Gál5Simon Mihály6Arpad Kovacs7Department of public health, Faculty of health science, Abu Dhabi University, Abu Dhabi, United Arab EmiratesDepartment of Medical Imaging, Faculty of Health Sciences, University of Pécs, Pécs, HungaryDepartment of public health, Faculty of health science, Abu Dhabi University, Abu Dhabi, United Arab EmiratesDepartment of public health, Faculty of health science, Abu Dhabi University, Abu Dhabi, United Arab EmiratesDepartment of Oncoradiology, Faculty of Medicine, University of Debrecen, Debrecen, HungaryDepartment of Oncoradiology, Faculty of Medicine, University of Debrecen, Debrecen, HungaryDepartment of Oncoradiology, Faculty of Medicine, University of Debrecen, Debrecen, HungaryDepartment of Oncoradiology, Faculty of Medicine, University of Debrecen, Debrecen, HungaryBackgroundGlioblastoma multiforme (GBM) is an aggressive brain tumor with a poor prognosis, often managed with radiotherapy. Two primary modalities, three-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT), differ in their precision and impact on survival, side effects, and OAR sparing. However, their comparative benefits remain unclear. This meta-analysis evaluates 3D-CRT and IMRT in GBM treatment, focusing on dosimetric parameters, toxicity, and OAR sparing, with an exploratory analysis of overall survival (OS).MethodsA systematic review of 19 studies was conducted, comparing dosimetric and side effects, including planning target volume (PTV) doses (Dmean, Dmax, and Dmin), conformity and homogeneity indices, and OAR sparing.ResultsIMRT provided significant dosimetric advantages, with higher PTV Dmean (mean difference (MD) 1.26 Gy; 95% CI: 0.22–2.31; P = 0.02) and better conformity index (MD −0.21; 95% CI: −0.33 to −0.08; P = 0.001). IMRT significantly reduced doses to healthy brain (MD −1.08 Gy; 95% CI: −2.08 to −0.09; P = 0.03), brainstem (MD −0.66 Gy; 95% CI: −1.18 to −0.15; P = 0.01), optic chiasm (MD −4.93 Gy; 95% CI: −9.15 to −0.70; P = 0.02), right optic nerve (MD -5.82 Gy; 95% CI: −9.49 to −2.15; P = 0.002), and left optic nerve (MD −1.20 Gy; 95% CI: −1.77 to −0.63; P < 0.0001).ConclusionIMRT provides significant dosimetric benefits and potentially lower toxicity compared to 3D-CRT in GBM treatment. While an exploratory analysis suggests a possible OS benefit, this requires cautious interpretation due to study limitations. IMRT’s precision supports its use in GBM treatment.https://www.frontiersin.org/articles/10.3389/fphy.2025.1632620/fullglioblastoma multiforme (GBM)intensity-modulated radiotherapy (IMRT)three-dimensional conformal radiotherapy (3D-CRT)overall survival (OS)organs at risk glioblastoma multiforme (GBM)dosimetry |
| spellingShingle | Omar Freihat David Sipos Reham Kotb Maria Aamir Dóra Solymosi Kristóf Gál Simon Mihály Arpad Kovacs Three-dimensional conformal therapy vs. intensity modulated radiation therapy in GBM: survival, dosimetry, and side effects a systematic review and meta-analysis Frontiers in Physics glioblastoma multiforme (GBM) intensity-modulated radiotherapy (IMRT) three-dimensional conformal radiotherapy (3D-CRT) overall survival (OS) organs at risk glioblastoma multiforme (GBM) dosimetry |
| title | Three-dimensional conformal therapy vs. intensity modulated radiation therapy in GBM: survival, dosimetry, and side effects a systematic review and meta-analysis |
| title_full | Three-dimensional conformal therapy vs. intensity modulated radiation therapy in GBM: survival, dosimetry, and side effects a systematic review and meta-analysis |
| title_fullStr | Three-dimensional conformal therapy vs. intensity modulated radiation therapy in GBM: survival, dosimetry, and side effects a systematic review and meta-analysis |
| title_full_unstemmed | Three-dimensional conformal therapy vs. intensity modulated radiation therapy in GBM: survival, dosimetry, and side effects a systematic review and meta-analysis |
| title_short | Three-dimensional conformal therapy vs. intensity modulated radiation therapy in GBM: survival, dosimetry, and side effects a systematic review and meta-analysis |
| title_sort | three dimensional conformal therapy vs intensity modulated radiation therapy in gbm survival dosimetry and side effects a systematic review and meta analysis |
| topic | glioblastoma multiforme (GBM) intensity-modulated radiotherapy (IMRT) three-dimensional conformal radiotherapy (3D-CRT) overall survival (OS) organs at risk glioblastoma multiforme (GBM) dosimetry |
| url | https://www.frontiersin.org/articles/10.3389/fphy.2025.1632620/full |
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