Stupp Treatment With Intrathecal Injection of Thiotepa for Glioblastoma With Advanced Spread

Inclusion Criteria: * Aged 18 - 75, any gender. * Newly diagnosed WHO grade 4 brain tumor with at least one evaluable lesion, imaging suggesting ventricular or meningeal invasion. * History of intraoperative intraventricular or cisternal opening. * Malignant cells found in cerebrospinal fluid pre-radiotherapy. * ECOG score 0 - 2, expected survival≥3 months. * Stable neurological symptoms for over 7 days. * Neutrophil count≥1.5×10⁹/L, hemoglobin≥90 g/L, platelet count≥75×10⁹/L. * PT/INR and PTT≤1.5×upper limit of normal. * Total bilirubin≤1.5×upper limit of normal, AST and ALT≤1.5×upper limit of normal, albumin≥30 g/L, creatinine≤2×upper limit of normal, calculated or 24-hour urine creatinine clearance rate≥50 mL/min. * Agree to effective contraception from first to 3 months after last dose. Exclusion Criteria: * Pregnant or breastfeeding women. * Active infection within 7 days before starting study drug requiring IV antibiotics or therapeutic warfarin. * Other malignancies in past 5 years. * HIV/AIDS history; past immunodeficiency, or active autoimmune disease needing systemic treatment. * Severe medical, neurological, or psychiatric conditions preventing full adherence to study treatment or assessments. * Ventricular drainage tube rupture or inability to undergo lumbar puncture. * Uncontrolled chronic diseases like diabetes, CHF, liver cirrhosis, or CKD.