Radiotherapy – Temozolomide Information for Grade 3 to 4 Glioma – Astrocytoma – Glioblastoma

This patient information is aimed at patients who have been given a diagnosis of grade 3 to 4 astrocytoma/glioblastoma.

Aim of the patient information

This patient information is aimed at patients who have been given a diagnosis of grade 3 to 4 astrocytoma/glioblastoma.

This is a High Grade Primary Malignant brain tumour for which you will require a combination treatment of radiotherapy and chemotherapy.

This patient information aims to tell you what will happen throughout your treatment.


You will be invited to Lincoln County Hospital to have a mesh mask made of your face/head.

You will then have a CT scan with the fitted mask, which will be used to plan your radiotherapy treatment.  This takes place in the radiotherapy department.  Radiotherapy is likely to start 3 to 4 weeks after your consultation with the Neuro-Oncologist.

Radiotherapy is given over a period of 6 weeks, so you will have a total of 30 visits = 30# (fractions). (1 radiotherapy treatment = 1#/fraction).

You will attend the hospital daily from Monday to Friday but NOT weekends.  Each visit you will have a single fraction (#) of radiotherapy.  This will take around 10 minutes, the first visit being a little longer.


Chemotherapy will also be prescribed over this period of time.  This is an oral medication; the dose is prescribed according to your weight and height.  You will be asked to take your chemotherapy, called Temozolomide, daily 1 to 2 hours before your slotted time for radiotherapy. Temozolomide is to be taken on an empty stomach where possible.

Temozolomide is ALSO taken on a Saturday and Sunday, so for a total of 42 days. You may also be advised to take anti-sickness medication 1 hour prior to taking your Temozolomide.

If you have symptoms of nausea you may be prescribed Metoclopramide or Ondansetron as an anti-sickness medication.

The day you start radiotherapy is the day you start Temozolomide; the day you complete radiotherapy is the day you complete Temozolomide.

You will be reviewed by the Neuro-Oncology team weekly during radiotherapy and chemotherapy with a weekly blood test to monitor effect on bone marrow.

Adjuvant Chemotherapy

Following completion of 6 weeks of radiotherapy and Temozolomide (Phase 1) you will have a 4-week break.  You will then be assessed for Adjuvant (further) cycles of Temozolomide (Phase 2).

Phase 2 – this will be a daily dose of Temozolomide taken for 5 days out of every 28 days for a maximum of 6 months.  This dose will be a higher dose than you have previously taken but over a shorter period of time.

You will then be monitored by your Neuro-Oncologist on a monthly basis with a blood test to assess effect on bone marrow.

Your first imaging post treatment is likely to be after your 2nd cycle of adjuvant Temozolomide.  This will be an MRI scan and will be used to compare subsequent (following) imaging.

Clinical Nurse Specialist (CNS) contact details

Should you have any questions before, during or after your treatment please contact the Clinical Nurse Specialist in Neuro-Oncology on telephone 01522 572313.

Emergency Contact Numbers will be provided at start of treatment as below.

Oncology Assessment Unit:           telephone 01522 307841

Ingham Suite:                                   telephone 01522 572260/572261

(Both Monday to Friday 9.00am to 5.00pm)

Out of hours and at weekends/Bank Holidays:

Waddington Unit                              telephone 01522 307198/307199

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