radiation therapy in treating young patients with gliomas

Conditions: Brain Tumor; Central Nervous System Tumor

Summary: rationale: specialized radiation therapy that delivers radiation directly to the tumor may kill more tumor cells and cause less damage to normal tissue. purpose: this phase ii trial is studying how well radiation therapy works in treating young patients with gliomas.

objectives: primary * determine the marginal-failure rate in young patients with low-grade gliomas treated with reduced-field conformal radiotherapy. secondary * determine the progression-free survival, event-free survival, and overall survival rates of young patients treated with this regimen. * determine quality of life of patients treated with this regimen. * correlate mib-1 labeling index with progression-free survival and overall survival of these patients. outline: this is a multicenter study. patients undergo reduced-field conformal radiotherapy 5 days a week for 6 weeks in the absence of disease progression or unacceptable toxicity. quality of life is assessed at baseline or 6 weeks after completion of study treatment and then at 2 and 5 years (closed as of 10/27/2010). after completion of study treatment, patients are followed every 3 months for 2 years, every 6 months for 2 years, and then annually thereafter.

Eligibility criteria:
disease characteristics: * histologically confirmed\* low-grade glioma, including any of the following: * juvenile pilocytic astrocytoma (jpa) or pleomorphic jpa * diffuse astrocytoma, including any of the following subtypes: * fibrillary astrocytoma * gemistocytic astrocytoma * subependymal giant cell astrocytoma * pleomorphic xanthoastrocytoma * low-grade oligoastrocytoma * low-grade oligodendroglioma * low-grade glioma not otherwise specified note: \*patients with chiasmatic lesions who have contiguous extension of tumor into other regions of the visual pathway by ct scan or mri are eligible without histopathologic confirmation; repeat biopsy required for patients with recurrent tumors that enhance but whose initial tumor did not * measurable disease by radiography * meets any of the following criteria: * progressive nonresectable disease * any location in the brain * patients with a less than gross total resection are eligible provided they are symptomatic from their tumor or the risk from neurologic impairment with progression is high enough to warrant immediate treatment * has undergone biopsy only * must have received ≥ 1 course of prior chemotherapy (for patients \< 10 years of age) * prior chemotherapy optional (for patients ≥ 10 years of age) * no type-1 neurofibromatosis * no evidence of leptomeningeal dissemination patient characteristics: age * 3 to 20 performance status * ecog 0-2 or * karnofsky 50-100% (for patients \> 16 years of age) or * lansky 50-100% (for patients ≤ 16 years of age) life expectancy * at least 1 year hematopoietic * absolute neutrophil count ≥ 1,000/mm\^3 * platelet count ≥ 100,000/mm\^3 (transfusion independent) * hemoglobin ≥ 10.0 g/dl (transfusions allowed) hepatic * not specified renal * not specified other * not pregnant * negative pregnancy test * fertile patients must use effective contraception * not in status epilepticus, coma, or requiring assisted ventilation prior to study entry * patients with a seizure disorder are eligible provided they are on anticonvulsants and disease is well controlled prior concurrent therapy: biologic therapy * not specified chemotherapy * see disease characteristics * recovered from prior chemotherapy * no concurrent chemotherapy endocrine therapy * concurrent dexamethasone allowed provided patient has been on a stable dose for ≥ 2 weeks prior to study entry * concurrent dexamethasone allowed for symptoms of increased intracranial pressure radiotherapy * no prior radiotherapy surgery * see disease characteristics other * no other concurrent anticancer therapy

Keywords: childhood oligodendroglioma recurrent childhood cerebellar astrocytoma recurrent childhood cerebral astrocytoma childhood low-grade cerebral astrocytoma recurrent childhood visual pathway and hypothalamic glioma untreated childhood cerebellar astrocytoma untreated childhood visual pathway and hypothalamic glioma