REVIEW article
Front. Phys.
Sec. Medical Physics and Imaging
Volume 13 - 2025 | doi: 10.3389/fphy.2025.1632620
Three-dimensional conformal therapy vs intensity modulated radiation therapy in GBM: Survival, Dosimetry, and Side Effects a systematic Review and Meta-Analysis
Provisionally accepted
Omar Freihat1*
David Sipos2,3
Reham Kotb1Maria Aamir1Dóra Solymosi4Kristóf Gál4Simon Mihály4Arpad Kovacs4- 1Abu Dhabi University, Abu Dhabi, United Arab Emirates
- 2University of Pecs, Pecs, Hungary
- 3University of Pécs, Pecs, Hungary
- 4University of Debrecen, Debrecen, Hungary
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Background: Glioblastoma multiforme (GBM) is an aggressive brain tumor with a poor prognosis, often managed with radiotherapy. Two primary modalities, three-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT), differ in their precision and impact on survival, side effects, and OAR sparing. However, their comparative benefits remain unclear. This meta-analysis evaluates 3D-CRT and IMRT in GBM treatment, focusing on dosimetric parameters, toxicity, and OAR sparing, with an exploratory analysis of overall survival (OS).Methods: A systematic review of 19 studies was conducted, comparing dosimetric and side effects, including planning target volume (PTV) doses (Dmean, Dmax, and Dmin), conformity and homogeneity indices, and OAR sparing.Results: IMRT provided significant dosimetric advantages, with higher PTV Dmean (mean difference (MD) 1.26 Gy; 95% CI: 0.22-2.31; P = 0.02) and better conformity index (MD -0.21; 95% CI: -0.33 to -0.08; P = 0.001). IMRT significantly reduced doses to healthy brain (MD -1.08 Gy; 95% CI: -2.08 to -0.09; P = 0.03), brainstem (MD -0.66 Gy; 95% CI: -1.18 to -0.15; P = 0.01), optic chiasm (MD -4.93 Gy; 95% CI: -9.15 to -0.70; P = 0.02), right optic nerve (MD -5.82 Gy; 95% CI: -9.49 to -2.15; P = 0.002), and left optic nerve (MD -1.20 Gy; 95%
Keywords: glioblastoma multiforme (GBM), Intensity-modulated radiotherapy (IMRT), Three-dimensional conformal radiotherapy (3D-CRT), Overall survival (OS), Organs at Risk Glioblastoma Multiforme (GBM), Dosimetry, Toxicity, Organs at Risk
Received: 21 May 2025; Accepted: 18 Jul 2025.
Copyright: © 2025 Freihat, Sipos, Kotb, Aamir, Solymosi, Gál, Mihály and Kovacs. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Omar Freihat, Abu Dhabi University, Abu Dhabi, United Arab Emirates
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