This title slide focuses on "Radiation-Induced Lymphopenia in Glioblastoma," highlighting its impact in the context of glioblastoma treatment. The subtitle describes a study on the Stupp Protocol and strategies to avoid Radiation-Induced Lymphopenia (RIL).

Radiation-Induced Lymphopenia in Glioblastoma

Study on Stupp Protocol & Strategies to Avoid RIL

This agenda slide outlines a presentation on the RIL & Stupp Protocol, starting with an introduction, followed by study population and ALC monitoring. It then covers dose exposure analysis for sinuses, brain, and facial bones, prevention strategies, and concludes with key findings and references.

Presentation Overview

1. 1. Introduction to RIL & Stupp Protocol
2. 2. Study Population & ALC Monitoring
3. 3. Dose Exposure Analysis

Sinuses, brain, and facial bones exposure.

4. 4. Prevention Strategies
5. 5. Key Findings & References

Source: RIL in Glioblastoma: Stupp Protocol Study

Radiation-Induced Lymphopenia (RIL) is lymphocyte depletion caused by radiotherapy, commonly seen in glioblastoma (GBM) patients on the Stupp protocol, especially without prior glucocorticoids or immunosuppressants. It impairs survival and antitumor immunity.

What is Radiation-Induced Lymphopenia (RIL)?

• Lymphocyte depletion caused by radiotherapy
• Common in glioblastoma (GBM) patients on Stupp protocol
• Increased risk without prior glucocorticoids or immunosuppressants
• Impairs survival and antitumor immunity

Source: Research Study on RIL in GBM Patients

This section header slide focuses on the "Stupp Protocol Patient Cohort" (Section 04). It highlights glioblastoma patients who have not received prior glucocorticoids or systemic therapies (N=XX).

Study Focus: Patients on Stupp Protocol

04

Stupp Protocol Patient Cohort

Glioblastoma patients without prior glucocorticoids or systemic therapies (N=XX)

Source: Patient cohort diagram. Placeholder: N=XX patients, RCHT details.

85% of patients develop severe radiation-induced lymphopenia (grade 3+) during RCHT, with ALC recovery taking 3-6 months post-treatment. The slide highlights a mean sinus dose exposure of 28-35% and a critical ALC threshold below 1,000/μL for early detection.

ALC Monitoring Before, During & After RCHT

• 85%: Patients Develop Severe RIL

Grade 3+ lymphopenia during RCHT

• 3-6 months: ALC Recovery Time

Post-RCHT normalization period

• 28-35%: Sinus Dose Exposure

Mean ALC-relevant radiation dose

• <1,000/μL: Critical ALC Threshold

Early RIL detection marker Source: Study on RIL in Glioblastoma (Stupp Protocol)

The slide details doses measured in key sites—sinuses, brain, and facial bones—using dose distribution maps, crucial for assessing radiation-induced lymphopenia (RIL) risk in glioblastoma patients on the Stupp protocol without prior glucocorticoids or lymphocyte-suppressive therapies. It includes a table of mean dose exposures (in Gy) for these sites, currently with placeholders for study data.

Dose Exposure in Key Sites

Placeholder for study data. |

To avoid RIL in at-risk patients, implement intensive ALC monitoring before, during, and after RCHT, while limiting radiation doses to sinuses and facial bones. Additionally, use sparing techniques in RT planning and initiate early intervention for any ALC drops.

How to Avoid RIL in At-Risk Patients

• Intensive ALC monitoring schedule pre-, during, post-RCHT
• Limit radiation dose to sinuses and facial bones
• Apply sparing techniques in RT treatment planning
• Initiate early intervention for ALC drops

Source: Workflow for monitoring

The slide's key takeaways emphasize prioritizing ALC in non-pretreated GBM patients and optimizing RT to minimize bone/sinus exposure, with a closing call to routinely monitor ALC and discuss cases. It includes references like Stupp et al., a lymphocyte chart summary, and an invitation for Q&A, under the subtitle "Avoid RIL: Focus on ALC Monitoring."

Key Takeaways & References

**Key Takeaways:

• Prioritize ALC in non-pretreated GBM patients
• Optimize RT to minimize bone/sinus exposure

Closing: Prioritize ALC, Optimize RT.

Call-to-Action: Monitor ALC routinely; discuss cases.

References: [Placeholder: Study DOI, Stupp et al.]

Q&A. Thank you!

(Lymphocyte chart summary)***

Avoid RIL: Focus on ALC Monitoring

Source: Radiation-Induced Lymphopenia (RIL) in GBM: Stupp Protocol Insights*