Radiotherapy and nuclear medicine basics: glioblastoma adjuvant therapy: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Radiotherapy and nuclear medicine basics: glioblastoma adjuvant therapy

Sample item

After maximal safe resection of glioblastoma in a fit 50-year-old, which adjuvant regimen is standard?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Radiotherapy with concurrent and adjuvant temozolomide

The standard of care for fit patients is focal radiotherapy with concurrent and adjuvant temozolomide, which improves survival over radiotherapy alone. Whole-brain irradiation is not used for a focal tumour, observation is inadequate, and intrathecal methotrexate is for lymphoma.

Option by option

  • A. Intrathecal methotrexate

    Intrathecal methotrexate is used for central nervous system lymphoma.

  • B. Observation with serial MRI

    Observation allows early regrowth of an aggressive tumour.

  • C. Whole-brain radiotherapy alone

    Whole-brain radiotherapy alone gives inferior results and excess toxicity.

  • D. Radiotherapy with concurrent and adjuvant temozolomide (correct)

    Correct. Radiotherapy with temozolomide is the standard adjuvant treatment.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is D, Radiotherapy with concurrent and adjuvant temozolomide. The standard of care for fit patients is focal radiotherapy with concurrent and adjuvant temozolomide, which improves survival over radiotherapy alone.

Why is "Intrathecal methotrexate" not the answer?

Intrathecal methotrexate is used for central nervous system lymphoma.

Why is "Observation with serial MRI" not the answer?

Observation allows early regrowth of an aggressive tumour.

Why is "Whole-brain radiotherapy alone" not the answer?

Whole-brain radiotherapy alone gives inferior results and excess toxicity.

What concept does this question test?

It tests Radiotherapy and nuclear medicine basics: glioblastoma adjuvant therapy in Radiology. Whole-brain irradiation is not used for a focal tumour, observation is inadequate, and intrathecal methotrexate is for lymphoma.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Radiotherapy and nuclear medicine basics: glioblastoma adjuvant therapy?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.