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61 year old science journalist from Los Angeles. MGMT methylated multifocal GBM,
biopsy only. PS=1 post-op. Completes 1
st
cycle adjuvant TMZ with marked fatigue
and ongoing mild cognitive deficit. Patient and wife seek your advice on (a) whether
to go ahead with planned 5 week holiday to Italy for 30
th
wedding anniversary,
visiting relatives, and (b) whether to continue with adjuvant TMZ. You advise:
A. Cancel trip to Italy and continue adjuvant TMZ
B. Travel to Italy, continue TMZ while away and on return
C. Travel to Italy, take a break from TMZ, continue on
return
D. Decision to proceed with adjuvant TMZ depends on
result of MRI scan
E. Advise patient that benefit from adjuvant TMZ is
insufficient to justify fatigue and other toxicities