{
  "abstract": "Background:: Radiotherapy following maximal-safe resection is a cornerstone of treatment for high-grade gliomas (HGGs). However, the optimal clinical target volume (CTV) margin remains controversial. This study aimed to evaluate the safety, efficacy, and recurrence patterns associated with a reduced CTV margin in patients with HGGs, compared to standard RTOG-based planning.\n\nMethods:: In this multicenter, phase III randomized clinical trial, patients aged 18–75 years with newly diagnosed WHO-grade 3 or 4 gliomas were randomly assigned to receive adjuvant radiotherapy with either a standard 2-cm clinical target volume (CTV) margin (control group) or a reduced 1-cm margin (intervention group). The primary endpoint was progression-free survival (PFS), while the secondary endpoints included overall survival (OS) and patterns of recurrence.\n\nResults:: A total of 258 patients were enrolled, of whom 75.6% had grade 4 gliomas. After a median follow-up of 14.5 months, median PFS was 15 ± 1.25 months in the intervention group but it was 19 ± 2.71 months in the control group (hazard ratio [HR] = 1.32; 95% CI, 0.93–1.87; p = 0.121). Median OS was 22.0 ± 2.98 months in the intervention group, while it was not reached in the control group (HR = 1.52; 95% CI, 0.99–2.33; p = 0.057). Imaging progression occurred in 35% of patients in the intervention group and 32.2% in the control group (p = 0.637). In-field recurrence was the predominant pattern in both groups (84% vs. 83.8%; p = 0.829), with no significant increase in marginal or out-of-field failures associated with margin reduction.\n\nConclusion:: Reducing the clinical target volume (CTV) margin from 2 cm to 1 cm in the adjuvant radiotherapy of high-grade gliomas did not significantly affect progression-free survival (PFS), overall survival (OS), or recurrence patterns. These findings support the feasibility and safety of margin reduction, even in settings where three-dimensional conformal radiotherapy (3D-CRT) is the primary technique.",
  "abstract_shown": true,
  "affiliations": [
    "Cancer Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.",
    "Non-Communicable Diseases Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran.",
    "Cancer Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.",
    "Department of Public Health & Epidemiology, Mashhad University of Medical Sciences, Mashhad, Iran.",
    "Department of Neurological Surgery, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.",
    "Reza Radiotherapy and Oncology Center, Mashhad, Iran."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Kazem Anvari"
    },
    {
      "affs": [
        1
      ],
      "name": "Seyed Alireza Javadinia"
    },
    {
      "affs": [
        2
      ],
      "name": "Danial Fazilat-Panah"
    },
    {
      "affs": [
        3
      ],
      "name": "Habibollah Esmaily"
    },
    {
      "affs": [
        0
      ],
      "name": "Seyed Amir Aledavood"
    },
    {
      "affs": [
        0
      ],
      "name": "Sudabeh Shahidsales"
    },
    {
      "affs": [
        4
      ],
      "name": "Babak Ganjeifar"
    },
    {
      "affs": [
        5
      ],
      "name": "Mahdieh Dayyani"
    },
    {
      "affs": [
        0
      ],
      "name": "Parisa Rabiei"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/91vfkvkn0n7h5.bib",
  "cited_by": 0,
  "doi": "10.31557/apjcp.2026.27.6.2005",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13726373/",
  "id": "91vfkvkn0n7h5",
  "issns": [
    "1513-7368",
    "2476-762X"
  ],
  "landing_url": "https://doi.org/10.31557/apjcp.2026.27.6.2005",
  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research Article"
    ],
    [
      "openalex",
      "2716|Glioma Diagnosis and Treatment"
    ]
  ],
  "openalex": "W7165865206",
  "pdf_url": "https://journal.waocp.org/article_92219_c40624bbd670c2f5c4e89c7c5fe772ad.pdf",
  "pmcid": "PMC13726373",
  "pmid": "42345146",
  "published": "2026-06-18",
  "publisher": "Shahid Beheshti University of Medical Sciences",
  "ris": "https://research.draconitic.com/paper/91vfkvkn0n7h5.ris",
  "sources": [
    {
      "first_seen": "2026-11-05T12:22:44Z",
      "native_id": "PMC13726373",
      "source": "pmc",
      "url": "https://doi.org/10.31557/apjcp.2026.27.6.2005"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2716|Glioma Diagnosis and Treatment",
      "subfield": "human-genetics"
    }
  ],
  "title": "Comparing the Recurrence Patterns of Reduced-Margins vs. RTOG-Protocol in Adjuvant Chemoradiation of High-Grade Gliomas: A Multicenter, Open-Label, Randomized Controlled Trial",
  "title_text": "Comparing the Recurrence Patterns of Reduced-Margins vs. RTOG-Protocol in Adjuvant Chemoradiation of High-Grade Gliomas: A Multicenter, Open-Label, Randomized Controlled Trial",
  "type": "peer-reviewed",
  "updated_at": "2026-11-06T12:22:21Z",
  "url": "https://research.draconitic.com/paper/91vfkvkn0n7h5",
  "venue": "Asian Pacific Journal of Cancer Prevention : APJCP",
  "versions": []
}