Numerous trials have failed to improve treatment outcomes by escalating dose beyond 60 Gy for GBM. In the SPECTRO GLIO trial, 180 GBM patients receiving standard chemoradiation (60 Gy in 30 fractions with temozolomide) were randomized to receive a simultaneous integrated boost of 72 Gy. The SIB volume included tumor cavity, residual enhancement, and disease defined on MR spectroscopic imaging (MRSI). Unfortunately, there was no significant improvement in median OS with the 72 Gy SIB (22.2 v 22.6 months), nor was there an improvement in median PFS (7.8 v 8.6 months). | Laprie, Neuro Oncol
