A study looking at additional radiotherapy for glioblastoma before surgery to improve the outcome of treatment (POBIG)

Cancer type:

Brain (and spinal cord) tumours




Phase 1

This study is looking at having a single dose of radiotherapy targeting the glioblastoma before surgery. This is to reduce the growth of the tumour between surgery and radiotherapy after surgery. 

It is open to people in the Greater Manchester area who are:

  • newly diagnosed with glioblastoma and 
  • who are to have surgery followed by further treatment such as radiotherapy

More about this trial

A standard treatment Open a glossary item for treating glioma is to remove it by surgery and then to have further radiotherapy. The radiotherapy doesn’t start straight after surgery. This is to allow you to get better and for the wound to heal. 

Glioma is a fast growing tumour. It can grow in the time after surgery and before starting radiotherapy. Researchers think that giving a single radiotherapy treatment before surgery might slow the growth of the glioma. This is already done for other types of brain tumours and is safe. 

The main aims of this study are to find:

  • whether it is safe to give radiotherapy before surgery 
  • the safe dose of radiotherapy to give before surgery
  • the first sign on a scan Open a glossary item that might show whether radiotherapy before surgery helps to control the tumour

Who can enter

The following bullet points are a summary of the entry conditions for this study. Talk to your doctor or the study team if you are unsure about any of these. They will be able to advise you. 

Who can take part

You may be able to join this study if all of the following apply. You:

  • don’t need to have urgent or immediate surgery due to symptoms 
  • are newly diagnosed with glioblastoma
  • are planned to have surgery followed by radiotherapy 
  • have satisfactory blood test results
  • are able to give informed consent to take part in the study
  • are able to look after yourself but might not be able to do heavy physical work (performance status 0 or 1)
  • are at least 18 years old

Who can’t take part

You cannot join this study if any of these apply. You:

  • need to have immediate or urgent surgery 
  • are having surgery only to take a sample (biopsy Open a glossary item) of the tumour 
  • have or might have another cancer apart from non melanoma skin cancer Open a glossary item. You can join if had cervical cancer or prostate cancer that was completely removed by surgery. If you had prostate cancer your PSA Open a glossary item  must be no more than 0.1 ng/ml.
  • are not able to have an MRI scan Open a glossary item with a contrast medium Open a glossary item. This could be because you are allergic to the contrast medium used or you can’t be in confined spaces. 

Trial design

This is a phase 1 study. The team hope to include 18 people in the study. 

Everyone has a single treatment of radiotherapy before having surgery. You have surgery within a week of having the radiotherapy.

Before the radiotherapy you have a planning appointment. This is to make sure the radiotherapy goes where the doctor wants it to. 

Before or as part of the planning appointment you have a mask (shell) made that fits over your head. This is to help keep your head still while having radiotherapy. So your treatment is accurate as possible. You wear the mask during the planning appointment and during the radiotherapy treatment.  

Samples for research
Everyone gives blood samples for the study. Where possible the team take these when you have a thin tube (cannula Open a glossary item) already in your vein. This is when you have an MRI scan for the study. 

The team also want to collect samples of your tears. To do this they place a small piece of paper in the corner of your eye. This soaks up the tears. They do this before you have your MRI scan. Early research suggests that looking at tears could help with diagnosing and monitoring brain tumours. The team want to find out more.  

You don’t have to agree to have the tears samples taken.

Looking at oxygen levels in the glioma
The team want to look at the oxygen levels in the glioma after surgery. To do this you take a pimonidazole tablet about 12 hours before your surgery. Your body absorbs it and it goes to the glioma tissue and highlights where there is low oxygen. After surgery the team look at the glioma tissue in a laboratory to see where these areas are. 

You have a small dose of pimonidazole and so there shouldn’t be any side effects. Side effects of pimonidazole include:

  • generally feeling unwell
  • feeling confused, dazed or unsettled (disorientated)
  • sweating

This is not part of your treatment and won’t change your treatment plan in anyway. 

You don’t have to agree to do this. You can still take part in the study.

The team use all these samples to find out more about how to treat glioma. 

Hospital visits

You see the doctor a week before your radiotherapy. This is:

You have a COVID-19 test before and after radiotherapy. Your doctor will tell you more about this. 

As part of the routine care you have MRI scans:

  • after the radiotherapy 
  • after surgery and
  • before you start radiotherapy after surgery 

You have another CT scan after surgery before you start your course of radiotherapy

Side effects

The study team monitor you during treatment and afterwards. Contact your advice line or tell your doctor or nurse if any side effects are bad or not getting better. 
Side effects of radiotherapy to the brain include:

  • swelling of the brain
  • headaches
  • feeling or being sick
  • effects on how the brain works. This can cause difficulty with thinking, difficulty doing tasks, confusion and poor memory.
  • tiredness 
  • hair loss

We have information about the side effects of radiotherapy to the brain.

Your doctor will talk to you about the possible side effects of treatment and answer any questions you have before you agree to take part.



Recruitment start:

Recruitment end:

How to join a clinical trial

Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Chief Investigator

Dr Gerben Borst

Supported by

Medical Research Council (MRC)
The Christie NHS Foundation Trust

If you have questions about the trial please contact our cancer information nurses

Freephone 0808 800 4040

Last review date

CRUK internal database number:


Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Last reviewed:

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