Brain Tumours

Chemoradiation for GBM

• continuous temozolomide associated with lymphopenia – exacerbated by prior and concomitant steroid treatment

– prophylactic co-trimoxazole or pentamidine recommended if lymphocyte count <0.5 • adjuvant temozolomide associated with neutropenia, thrombocytopenia and fatigue • occasional patients experience pancytopenia during concomitant treatment • no increase in late neurotoxicity documented to date • ‘pseudoprogression’ on post-RT imaging – may reflect treatment related inflammation or necrosis – no validated imaging methods for discriminating progression from pseudoprogression