Stupp protocol (chemoradiation)

What it is

The Stupp protocol is the standard treatment regimen for glioblastoma. After surgery, it combines radiation therapy given together with the chemotherapy drug temozolomide (chemoradiation), followed by additional cycles of temozolomide. This approach improved survival compared with radiation alone.

Understanding Stupp protocol (chemoradiation)

Named after the trial that established it, the Stupp protocol is the backbone of glioblastoma treatment. It typically follows maximal safe surgery and consists of two phases: first, a course of radiation (commonly about six weeks) given concurrently with daily temozolomide; then, after a short break, additional cycles of temozolomide given on a monthly schedule. Combining radiation with temozolomide (rather than radiation alone) was shown to extend survival, making this the standard of care for eligible patients with glioblastoma. The benefit is greater in tumors with MGMT promoter methylation. The protocol is well-established and widely used, though it is adapted for individual circumstances (for example, hypofractionated radiation or modified approaches for older or frailer patients). Additional treatments (such as tumor treating fields) may be added. Understanding the Stupp protocol in gliomas clarifies the standard combined treatment for glioblastoma.

Why it matters

Understanding the Stupp protocol helps patients and families know the standard glioblastoma treatment — surgery followed by radiation with temozolomide and then more temozolomide — which improved survival over radiation alone.