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Mri brain with contrast and perfusion
NGS of the tumor?
Ok We will go for MRI within 7 days .
Sir is it 100 percent sure that recurrence will occur or there is any chance that recurrence will not occur again after GTR and radiation .
The role of temozolomide in unmethylated GBM remains a controversial issue; however, this patient has already had 4 cycles, and I would complete an additional 2 cycles to complete 6. Going by level 1 data, one could still potentially consider adding TTField therapy, as there is a randomized trial demonstrating survival advantage, irrespective of methylation status. NGS has a small probability of yielding an actionable mutation, but if possible, could be considered. Recurrence is most likely at some point down the line, although all of us have the very few exceptional patients that have become long-term survivors, and therefore, in someone who has had a gross total resection, I would never take hope away.
Pending Moderator approval.
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