For a patient with large volume glioblastoma, what do you do if they are found to have a subdural infection in the middle of chemoRT requiring repeat surgery?

In this scenario, the patient will likely stop the daily treatments for a variable period of time that I would estimate to be measured in weeks while recuperating from surgery and receiving IV antibiotics. When cleared for radiation, I would start by doing a new Simulation using an updated MRI to account for any intervening growth or anatomical changes. Based on standard radiobiological principles, I would calculate the makeup dose by multiplying 70 cGy by the number of days of interruption and adding the difference to the remaining undelivered dose from the original prescription. For example, if the interruption was for 15 days, the additional dose would be 70 x 15 = 1,050 cGy, which needs to be added to the remaining dose from the initial...