Brain Tumours

61 year old science journalist from Los Angeles. MGMT methylated multifocal GBM, biopsy only. PS=1 post-op. Completes 1 st cycle adjuvant TMZ with marked fatigue and ongoing mild cognitive deficit. Patient and wife seek your advice on (a) whether to go ahead with planned 5 week holiday to Italy for 30 th wedding anniversary, visiting relatives, and (b) whether to continue with adjuvant TMZ. You advise: A. Cancel trip to Italy and continue adjuvant TMZ B. Travel to Italy, continue TMZ while away and on return C. Travel to Italy, take a break from TMZ, continue on return D. Decision to proceed with adjuvant TMZ depends on result of MRI scan E. Advise patient that benefit from adjuvant TMZ is insufficient to justify fatigue and other toxicities