1. What is the decision or change (e.g. clinical topic, practice guideline, system design, delivery of care) you are facing or struggling with where a summary of the evidence would be helpful?

Radiation Therapy for WHO Grade 4 Adult-type Diffuse Gliomas: WHO grade 4 adult-type diffuse gliomas are the most common malignant brain tumors in adults, accounting for 48% of all cases. They exact a significant toll on life years worldwide, and among the approximately 10,000 individuals diagnosed each year in the United States. Therapeutic advances in recent years have, however, improved median survival and quality of life among patients with this disease.

2. Why are you struggling with this issue?

Here are the questions we are interested in...for all the reasons noted (new data/treatments, variation in practice, confirm best practices.

KQ1: What are the indications for radiation therapy in patients with newly diagnosed grade 4 adult-type diffuse gliomas, and how do systemic therapy and adjuvant tumor treating fields (TTF) modify its effects?

KQ2: What is the optimal dose-fractionation regimen for external beam radiation therapy after biopsy/resection in patients with grade 4 adult-type diffuse gliomas, and how might treatment vary based on pretreatment characteristics (e.g., age or performance status)?

KQ3: What are the ideal target volumes and techniques for definitive external beam radiation therapy in patients with grade 4 adult-type diffuse gliomas?

KQ 4: What are the indications for re-irradiation in patients with grade 4 adult-type diffuse glioma patients whose disease recurs following completion of standard first-line therapy?

3. What do you want to see changed? How will you know that your issue is improving or has been addressed?

The review would be used to replace an existing evidence-based guideline, originally published in 2016, with a new version. There are important new data from major trials that have contributed to changes in practice in the use of radiation therapy in this setting. Additional trials are also expected to be published during the likely literature period for this review. The review would help us to address revised questions related to WHO grade 4 adult-type diffuse gliomas and provide new recommendations for radiation oncologists, which would also be of interest to medical oncologists and surgeons.

4. When do you need the evidence report?

Mon, 05/01/20 23

5. What will you do with the evidence report?

The systematic review will be used to update our current Glioblastoma guideline. This guideline was last updated in 2016 so it is definite need to be replaced as new data have published.

Optional Information About You

What is your role or perspective? Professional society

If you are you making a suggestion on behalf of an organization, please state the name of the organization American Society for Radiation Oncology

May we contact you if we have questions about your nomination? Yes