Phase II Trial of Neo-adjuvant Temozolomide Prior to Combined Temozolomide and Concurrent Accelerated Hypofractionated External Beam Radiotherapy Followed by Adjuvant Temozolomide in Patients With Newly Diagnosed Glioblastoma Multiforme

Inclusion Criteria: * Age: 18 years or older * Histological confirmation of supratentorial GBM * KPS \> 60 * Neurological function 0 or 1 * Adequate bone marrow as defined below: * absolute neutrophil count (ANC) \> 1500 cells/mm3 * platelets \> 100,000 cells/mm3 * hemoglobin \> 10g/dl * Adequate renal function as defined below: * BUN \< 25mg/dl within 14 days prior to study registration * creatinine of 63 to 103 umol/L within 14 days prior to study registration * Adequate hepatic function as defined below: * Bilirubin of 3 to 21 umol/L within 14 days prior to study registration * ALT \& AST \< 3xnormal range within 14 days prior to study registration * Neoadjuvant TMZ to start within 3 weeks of surgery/biopsy if no resection was deemed feasible * A diagnostic contrast-enhanced MRI or CT scan of the brain must be performed preoperatively and postoperatively. * History, physical and neurological examination within 14 days prior to study registration. * For females of child-bearing potential, negative pregnancy test within 72 hours prior to starting TMZ. * Able to sign an informed study-specific consent Exclusion Criteria: * Margin of contrast-enhanced residual mass closer than 15mm from the optic chiasm or optic nerves. * Prior invasive malignancy, unless disease-free for \>3years * Recurrent or multifocal GBM * Severe co-morbidities such as * unstable angina * transmural myocardial infarction within 6 months * COPD at the time of registration * Hepatic insufficiency * Bacterial or fungal infection requiring IV antibiotics at the time of registration * Acquired Immune Deficiency Syndrome (AIDS) * Major medical illnesses or psychiatric impairments * Pregnant women or lactating women