How do you decide between re-irradiation, chemotherapy, and alternating electric field therapy in patients with relapsed GBM post chemoradiation with TMZ?

The best care for patients with glioblastoma is multi-disciplinary. For that reason, we review these patients in our tumor board. The critical questions are - 1) Is this truly disease progression or could it be radiation necrosis/ pseudoprogression? 2) What functions are located in the area of recurrence? 3) How clinically functional is the patient? 4) how long ago was the radiation? 5) Did the patient complete their adjuvant temozolomide cycles? How long ago?

If the tumor is NOT in a critical lo...