Glioblastoma Multiforme (GBM) is one of the most common – and most aggressive – of brain cancers, responsible for more years of life lost per patient than any other common adult cancer. GBM tumours show rapid and extensive microscopic infiltration of tumour cells away from the primary disease site and into normal brain tissue; making combination treatment with surgery, radiotherapy and chemotherapy challenging and overall medial survival extremely poor. This microscopic infiltration is not visible on magnetic resonance imaging (MRI), so to try and avoid missing these invading tumour cells, a large “safety margin” around the primary tumour is included in the high-dose radiotherapy field, causing a large volume of normal brain surrounding the tumour to be irradiated with significant toxicity. Identical margins are typically used for these margins for GBM radiotherapy, irrespective of an individual patient’s tumour location or biology.
The aims of AGORA-RT
We aim to change this “one size fits all” approach and show the feasibility of an individualised approach for optimising radiotherapy fields. We will use mathematical models of tumour growth and infiltration, guided by data from MRI, with the aim of improving outcomes and reducing toxicity.
The white outline, indicated by the arrow, is the tumour as contoured in the clinic. White matter tracts, along which tumour cells prefer to spread, are shown as coloured lines. The coloured 'heatmap' represents the computationally predicted extent of tumour infiltration after 30 days, as a probability from 0% to 100% (in red).