Daily Temozolomide for Elderly Patients With Unmethylated MGMT- Promoter Newly Diagnosed GliOblatoma

Inclusion Criteria: * Age ≥65 years. * Histopathologically confirmed newly diagnosed WHO grade 4, IDH wild-type GBM * Unmethylated MGMT promoter, according to local assessment * Completed treatment with 40 Gy in 15 fractions over three weeks, with concurrent TMZ, within six weeks prior to enrollment * Eastern Cooperative Oncology Group (ECOG) performance status scale of 0, 1, or 2. * Karnofsky Performance Status (KPS) ≥60. * Adequate organ function, as defined by the following laboratory values obtained within 28 days prior to enrollment: * Absolute neutrophil count (ANC) \>1.5 × 10⁹/L (1,500 cells/mm³). * Platelet count \>100 × 10⁹/L (100,000 cells/mm³). * Serum creatinine \<1.5 times the upper limit of normal. * Total serum bilirubin \<1.5 times the upper limit of normal. * ALT (SGPT) \<2.5 times the upper limit of normal and/or AST (SGOT) \<2.5 times the upper limit of normal. * Signed informed consent (and assent, if applicable) must be obtained from the participant or their legal representative, ensuring the participant's ability to adhere to the study requirements. Exclusion Criteria: * Diffuse leptomeningeal involvement at the time of diagnosis. * Inability to undergo contrast-enhanced magnetic resonance imaging (MRI) * Known hypersensitivity to TMZ components or Dacarbazine * Severe myelosuppression * Active hepatitis B infection * Severe or uncontrolled medical conditions (e.g., active systemic infection, diabetes, hypertension, coronary artery disease,…