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After the radiation and temozolomide has taken place, then we really start to get into the kind of long-term maintenance phase or an adjuvant chemotherapy. Again, usually that’s dosed given with temozolomide and temozolomide is typically dosed five out of 28 days. Blood work is typically drawn on days 21 and 28 of each of the 28 day cycles. It’s very, very important for myself and my assistants to work with family members and the patient to determine exactly when they start their chemotherapy. And when they’re supposed to be getting their blood work performed, to show ensure safety and proper care of the patient. Some people will describe some degree of fatigue during the adjuvant portion, a la therapy that is only with the temozolomide. It can occur though, not to the degree of the fatigue that’s experienced during the radiation temozolomide. Usually we’ll have patients have their oral temozolomide or chemo adjuvant chemotherapy for up to a year. If in fact they have no additional tumor progression, then they’ll come off therapy. During the course of their adjuvant therapy, things can be perfectly stable and really not have any new deficits or individuals can experience seizures during their course of adjuvant therapy. That can herald tumor growth. But sometimes it really doesn’t herald any tumor growth and it really is just a function of their surgical intervention and the brain injury that they’ve sustained from their surgery.
