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Study aim: Comparison of recurrence pattern and treatment outcomes in patients with high-grade glioma managed by adjuvant radiotherapy based on standard protocol of RTOG with treatment by smaller margin. Design: A randomized phase 3 clinical trial ,with single-blinded outcome assessment, with a parallel group design of 192 patients . randomization will carry out with block randomization. Settings and conduct: This study will be done as a multicenter trial in Mashhad ,Tehran, Babol and Sabzevar cities. Patients participating in this trial will be blind. Participants/Inclusion and exclusion criteria: Inclusion criteria: Newly diagnosed patients with glioblastoma and anaplastic astrocytoma and oligodendroglioma who have pathology evidence Age 18-75 years KPS≥70% Exclusion criteria: Uncontrolled comorbidities such as diabetes or hypertension that make radiotherapy and chemotherapy infeasible Impossibility of surgery and sampling Intervention groups: Patients in the intervention group will undergo radiotherapy to the lesion (46 gray dose in 23 fractions to a margin of 1 cm to the high signal region in the , T2/ FLAIR sequences in MRI (residual tumor plus tumor bed removed plus surrounding edema) and boost dose to total of 60 gray to a 1cm margin to the enhancive lesion in the T1 weighted MRI (residual tumor) and tumor bed. Patients in the control group (Based on the RTOG protocol)will undergo radiotherapy to the lesion (46 gray dose in 23 fractions to a margin of 2 cm to the high signal region in the T2/ FLAIR sequences in MRI (residual tumor plus tumor bed removed plus surrounding edema) and boost dose to total of 60 gray to a 2cm margin to the enhancive lesion in the T1 weighted MRI (residual tumor) and tumor bed. Main outcome variables: Overall survival Progression free survival Pattern of failure
IRCTID: IRCT20210215050367N1
  1. The comparison of transforming growth factor beta-1 serum levels in early-stage breast cancer patients treated with external beam whole breast irradiation plus boost versus interstitial brachytherapy accelerated partial breast irradiation
  2. Comparison of short term results of IORT boost and hypofractionated EBRT after BCS with conventional whole breast radiotherapy and external boost in early breast cancers from 2019 to 2020
  3. Comparing the effect of neoadjuvant temozolomide before chemoradiotherapy with chemoradiotherapy followed by adjuvant temozolomide on progression free survival in patients with Glioblastoma
  4. Quantitative Investigation of Brain Glioma Tumor Changes After Radiation Therapy by 3D Comparative Method Using MRI Diffusion Images about predicting response to treatment
  5. Results of intraoperative radiotherapy as a boost in non-metastatic breast cancer undergoing breast conservation surgery
  6. Comparison of pathologic response & safety in standard neoadjuvant therapy versus concomitant boost radiotherapy in patient with localy advanced rectal cancer reffered to cancer institute from 2021 to 2024.
  7. Comparing toxicity and cosmetic outcome of conventional and hypo fractionated radiotherapy with or without boost in breast cancer patients
  8. Comparison Of Local Control And Complications Of Hypofractionated Radiotherapy With Conventional In Patients With Advanced Breast Cancer
  9. Assessment of Tolerability, Response and Complications of Capecitabin added to Cisplatine for Concurrent Chemoradiation of Muscle Invasive Bladder Cancer
  10. To evaluate the safety and efficacy of simultaneous integrated boost in neoadjuvant short-course radiotherapy for rectal cancer A phase II clinical trial
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