In what situations would you routinely offer 25 Gy / 5 fx for glioblastoma?  

We do not routinely use this fractionation scheme given the limited data generated with this schedule to date. In general, we reserve this only for the elderly, frail patients, who cannot commute for a 15 fraction or longer schedule. In practice, if more than 2/3 of the brain volume is going to be e...

We use this regimen in two situations, based on clinical need. Ultra short course in very poor performers unwilling for more elaborate treatment and needing very short term palliation. Recurrent GBM's, not resectable but reasonable targets for SRS, but too large for single session 15-17Gy in one...

25 Gy/5 has been used in elderly patients with glioblastoma or patients with poor performance status. Several other hypofractionation schedules from 34 Gy/10 to 40 Gy/15 have also been used. Many years ago (before temozolomide), we performed a small trial using 50 Gy/10 and found that patients with ...

Outside of a study, I have never used a 5 fraction regimen for treating glioblastoma. But I have often used relatively short regiments, eg, 3000-4500 cGy in 10-15 fractions. I have used 3000/10fx for patients with very large volume disease since we know it is generally safe for whole brain. And I ha...