Advances in Artificial Intelligence for Glioblastoma Radiotherapy Planning and Treatment.

Glioblastoma is an aggressive central nervous system tumor characterized by diffuse infiltration. Despite substantial advances in oncology, survival outcomes have shown little improvement over the past three decades. Radiotherapy remains a cornerstone of treatment; however, it faces several challenges, including considerable inter-observer variability in clinical target volume delineation, dose constraints associated with adjacent organs at risk, and the persistently poor prognosis of affected patients. Recent advances in artificial intelligence, particularly deep learning, have shown promise in automating radiation therapy mapping to improve consistency, accuracy, and efficiency. This narrative review explores current auto segmentation frameworks, dose mapping, and biologically informed radiotherapy planning guided by multimodal imaging and mathematical modeling. Studies have demonstrated reproducible tumor segmentations with DSCs exceeding 0.90, reduced planning within minutes, and emerging predictive capabilities for treatment response. Radiogenomic integration has enabled imaging-based classification of critical biomarkers with high accuracy, reinforcing the potential of deep learning models in personalized radiotherapy. Despite these innovations, deployment into clinical practice remains limited, primarily due to insufficient external validation and single-institution training datasets. This review emphasizes the importance of large, annotated imaging datasets, multi-institutional collaboration, and biologically explainable modeling to successfully translate deep learning into glioblastoma radiation planning and longitudinal monitoring.