TMZ Plus Apatinib in Newly Diagnosed High-grade Glioma：RCT

Inclusion Criteria:

1. Age ≥ 18 years;
2. Pathological or cytological diagnosis of glioma (WHO Ⅲ or Ⅳ);
3. KPS score ≥ 60;
4. The expected survival period is ≥ 3 months;
5. Blood routine examination is basically normal: a. HB ≥ 90 G /L; b. the ANC ≥ 1.5 x 10\^9/L; c. PLT≥ 80 x 10\^9/L (without blood transfusion within 2 weeks, or G-CSF and other hematopoietic stimulator correction) ;
6. Normal liver and kidney function.

Exclusion Criteria:

1. Pregnant or lactating women;
2. Second primary malignancy;
3. Severe lung infection;
4. with high blood pressure although treated with medication;
5. Patients with myocardial ischemia or myocardial infarction, arrhythmia (including QT interval \> 440 ms) or grade II cardiac insufficiency;
6. Conditions that significantly affect oral drug absorption, such as inability to swallow, chronic diarrhea, and intestinal obstruction;
7. Abnormal coagulation function （INR\>1.5 or PT\>ULN+4s or APTT \>1.5 ULN);
8. Haemorrhagic tendencies or being treated with thrombolysis or anticoagulation;
9. ≥CTCAE level 2 Pulmonary hemorrhage or ≥CTCAE level 3 other organ hemorrhage occurred within 4 weeks before the first administration of the study drug;
10. Arteriovenous thrombosis in 6 months prior to first administration, Such as cerebrovascular accident (including temporary ischemic attack), deep vein thrombosis and pulmonary embolism;
11. Small doses of warfarin(1mg/day) or heparin(80-100mg/day) is permitted unless INR ≤1.5;
12. Serious heart, lung and bone marrow impairment;
13. History of severe hypertension or cerebral hemorrhage