IMRT. 46 Gy in 200s followed by boost to 60. GTV1 = T1 enhancement + T2 FLAIR. CTV1=GTV +2cm. boost: GTV2+T1 enchancement. CTV2=GTV2+2cm. PTV=CTV+0.3-0.5cm.
For letters of medical necessity:
GBM data:
We recommend that he receive radiation as well as Temodar as this is the standard of care established by Stupp and others which was published in the New England Journal of Medicine in 2005 demonstrating a survival benefit with Temodar and radiation versus radiation only. Radiation has long been established as the standard of care postoperatively as early as the late 1970s by M. D. Walker and colleagues in the Journal of Neurosurgery
(1978) and again in the New England Journal of Medicine (1980).
