When do you start temozolomide with RT for high grade glioma?

Thanks! Will be interesting to see the differing views. I was "brought up" in residency to believe that TMZ is a radiosensitizer, but have been thinking about it more closely; why an alkylator would synergize with RT seems increasingly unclear to me.

Many people say it acts as radiosensitizer from cl...

Radiobiological experiments have shown radiosensitization with concurrent TMZ and RT, with highest cell kill when given together followed by the sequence of TMZ followed by RT, with worse killing when TMZ is done after RT.

Also continuous exposure to TMZ gives better cell killing with fractionated. ...