ArticleNeuro-oncology advances
A multi-institutional pilot clinical trial of spectroscopic MRI-guided radiation dose escalation for newly diagnosed glioblastoma.
Article in Neuro-oncology advances. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03137888 (Pilot Study of Spectroscopic MRI-Guided, Dose-Escalated Radiation Therapy for Newly-Diagnosed Glioblastoma), which is not on this map. Cited by 37 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Pilot Study of Spectroscopic MRI-Guided, Dose-Escalated Radiation Therapy for Newly-Diagnosed Glioblastoma
Who cites it
37 citing papers in PubMed, 40 citations in OpenAlex.
- Personalized machine learning-guided radiation dose escalation in newly diagnosed glioblastoma: prospective pilot study.Nature communications · 2026Trial
- Randomized phase III trial of metabolic imaging-guided dose escalation of radio-chemotherapy in patients with newly diagnosed glioblastoma (SPECTRO GLIO trial).Neuro-oncology · 2024Trial
- The STEMRI trial: Magnetic resonance spectroscopy imaging can define tumor areas enriched in glioblastoma stem-like cells.Science advances · 2023Trial
- Applying a Radiation Therapy Volume Analysis Pipeline to Determine the Utility of Spectroscopic MRI-Guided Adaptive Radiation Therapy for Glioblastoma.Tomography (Ann Arbor, Mich.) · 2023Trial
- A Novel Approach to Determining Tumor Progression Using a Three-Site Pilot Clinical Trial of Spectroscopic MRI-Guided Radiation Dose Escalation in Glioblastoma.Tomography (Ann Arbor, Mich.) · 2023Trial
- White matter pathlength maps from diffusion-weighted MRI tractography for radiotherapy target planning in glioblastoma.Journal of neuro-oncology · 2026Article
- Optical microscopy predictions of focal recurrence in glioblastoma.Science advances · 2026Article
- Quantitative magnetic resonance imaging for accurate delineation of radiotherapy: a narrative review.Translational cancer research · 2026Review
- Radiation Effects on Normal Brain in Subjects With Recurrent Glioblastoma by Spectroscopic MRI.NMR in biomedicine · 2026Article
- Imaging Biomarkers in Radiotherapy.Cancers · 2026Review
- Ultrafast J-resolved magnetic resonance spectroscopic imaging for high-resolution metabolic brain imaging.Nature biomedical engineering · 2025Article
- Glioblastoma in adults: A Society for Neuro-Oncology (SNO) and European Society of Neuro-Oncology (EANO) consensus review on current management and future directions.Neuro-oncology · 2025Review
- MRI for biology-guided radiation therapy: Are we there yet? A summary of the 2024 ISMRM member-initiated session.Magnetic resonance in medicine · 2025Review
- Longitudinal Overlap and Metabolite Analysis in Spectroscopic MRI-Guided Proton Beam Therapy in Pediatric High-Grade Glioma.Tomography (Ann Arbor, Mich.) · 2025Article
- Defining occult disease in glioblastoma using spectroscopic MRI: implications for clinical target volume delineation.Radiation oncology (London, England) · 2025Article
- Magnetic resonance spectroscopy guided radiotherapy boost for patients with glioblastoma.Scientific reports · 2025Article
- T1 Gadolinium-Enhanced Magnetic Resonance Imaging of Glioblastoma: What You See Is Not What You Get.International journal of radiation oncology, biology, physics · 2025Article
- Article
- Detecting glioblastoma infiltration beyond conventional imaging tumour margins using MTE-NODDI.Imaging neuroscience (Cambridge, Mass.) · 2025Article
- Radiotherapeutic advances in the management of glioblastoma.Journal of neuro-oncology · 2024Review
Corrections and comments
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Authors and funding
19 authors at 4 institutions in 1 country.
Funding
Abstract
Background: Glioblastomas (GBMs) are aggressive brain tumors despite radiation therapy (RT) to 60 Gy and temozolomide (TMZ). Spectroscopic magnetic resonance imaging (sMRI), which measures levels of specific brain metabolites, can delineate regions at high risk for GBM recurrence not visualized on contrast-enhanced (CE) MRI. We conducted a clinical trial to assess the feasibility, safety, and efficacy of sMRI-guided RT dose escalation to 75 Gy for newly diagnosed GBMs. Methods: Our pilot trial (NCT03137888) enrolled patients at 3 institutions (Emory University, University of Miami, Johns Hopkins University) from September 2017 to June 2019. For RT, standard tumor volumes based on T2-FLAIR and T1w-CE MRIs with margins were treated in 30 fractions to 50.1 and 60 Gy, respectively. An additional high-risk volume based on residual CE tumor and Cho/NAA (on sMRI) ≥2× normal was treated to 75 Gy. Survival curves were generated by the Kaplan-Meier method. Toxicities were assessed according to CTCAE v4.0. Results: Thirty patients were treated in the study. The median age was 59 years. 30% were MGMT promoter hypermethylated; 7% harbored IDH1 mutation. With a median follow-up of 21.4 months for censored patients, median overall survival (OS) and progression-free survival were 23.0 and 16.6 months, respectively. This regimen appeared well-tolerated with 70% of grade 3 or greater toxicity ascribed to TMZ and 23% occurring at least 1 year after RT. Conclusion: Dose-escalated RT to 75 Gy guided by sMRI appears feasible and safe for patients with newly diagnosed GBMs. OS outcome is promising and warrants additional testing. Based on these results, a randomized phase II trial is in development.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.