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Age ≥35 years.
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Male or female.
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New radiological diagnosis of glioblastoma.
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Performance status judged by World Health Organisation, Eastern Cooperative Oncology Group [ECOG] score = 0–1.
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Case has been reviewed by Neuro-oncology multidisciplinary team (MDT – neurosurgeon, clinical oncologist, radiologist and pathologist); MDT consensus that offering study entry is clinically appropriate and safe i.e. patient unlikely to come to harm (e.g. hydrocephalus) from delayed surgery and pre-operative radiotherapy based on available clinical information and imaging.
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Confirmation at first clinic visit that study entry is clinically appropriate and safe (e.g. lack of severe and debilitating symptoms of raised intracranial pressure).
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Intention to treat with surgical resection and postoperative adjuvant therapy as per current standard of care (Stupp regimen).
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Tumour size, location and configuration meet radiotherapy treatment planning criteria (e.g. to secure cold spot/hot spot, meets dose constraints for organs at risk when accounting for post-operative radiotherapy).
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Adequate haematological and biochemical parameters for surgery and contrast agent administration (full blood count and coagulation profile deemed acceptable by clinical team, eGFR >30 ml/min).
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Mental capacity to consent for treatment.
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Able and willing to give informed consent.
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Planned biopsy procedure only.
Suspicion of other tumour on CT body scan or known malignancy except non-melanoma skin cancer, completely resected cervical or prostate cancer (with Prostate Specific Antigen of less than or equal to 0.1 ng/ml) within the past 3 years.
Contraindications to contrast-enhanced MRI scanning (e.g. claustrophobia, gadolinium allergy).
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