High-grade gliomas account for approximately 59% of all primary brain tumors in adults in India. They are rapidly growing tumors that directly invade the brain parenchyma but almost never metastasize outside the CNS. They present in any age group, although most occur in late adulthood. GBM accounts for approximately 75% of all high-grade gliomas. Treatment for high grade gliomas involve a multidisciplinary approach which include neurosurgeons, radiation oncologists, physicists and medical oncologists. However, high grade gliomas carry poor prognosis with standard treatments, due to the nature of disease and its close proximity to vital structure in the central nervous system.

This will be a single institutional, prospective, interventional study. Eligible patients

of high grade gliomas will undergo proper clinical examination, laboratory

and imaging investigations. Three simultaneous radiation treatment plans will be generated, one of Sequential Boost and two of Simultaneous Integrated Boost RT. At the end of treatment planning, all the plans would be compared in terms of Planning Total Volume coverage, sparing of Organs At Risk, Homogeneity Index and Conformity Index. Patients would be followed up for response assessment, toxicity profiles, OS, PFS, and neurocognitive function.