Abstract
Since the efficacy of postoperative radiotherapy for high-grade gliomas was confirmed in the 1970s, many clinical studies have been performed to optimize dose fractionation, target volume, and concurrent therapy. Some major and drastic changes in radiation therapy over the following decades, including radiotherapy planning from 2D to 3D, use of high beam energy from gamma rays to megavoltage X-rays, and the incorporation of modern imaging modalities to radiotherapy planning, have been accompanied with a considerable improvement in outcome for this disease. However, the local control rate remains unsatisfactory even in the most recent reports, and besides, several practical considerations, such as shortening of treatment time and re-irradiation of recurrent disease, require new treatment approaches. Excellent dose distribution and accurate targeting techniques have also been established by recent progress in high precision radiation therapy, which may further contribute to improving outcomes as one of the treatment strategies.
