radiation therapy followed by carmustine in treating patients who have supratentorial glioblastoma multiforme

Conditions: Brain and Central Nervous System Tumors

Summary: rationale: radiation therapy uses high-energy x-rays to damage tumor cells. drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. purpose: phase ii trial to study the effectiveness of radiation therapy followed by carmustine in treating patients who have supratentorial glioblastoma multiforme.

objectives: * determine the overall and progression-free survival in patients with supratentorial glioblastoma multiforme treated with accelerated radiotherapy and conformal stereotactic radiotherapy boost followed by carmustine. * determine the short and long-term toxicity of this regimen in these patients. * determine the feasibility of this regimen in these patients. outline: patients receive daily accelerated radiotherapy 5 days a week on weeks 1-2. on weeks 3-6, patients receive accelerated radiotherapy 4 days a week (3 days a week on week 6) and conformal stereotactic radiotherapy boost once weekly. patients then receive carmustine iv over 1-2 hours on days 1-3 every 8 weeks for 6 courses beginning within 1 month after the completion of radiotherapy. patients are followed every 3 months for 2 years, every 6 months for 3 years, and then annually thereafter. projected accrual: a total of 76 patients will be accrued for this study within 15 months.

Eligibility criteria:
disease characteristics: * histologically confirmed supratentorial glioblastoma multiforme by surgical biopsy or resection within 5 weeks of study * postoperative residual contrast enhancing tumor and resection tumor cavity together no greater than 60 mm in maximum diameter * no well-differentiated or anaplastic astrocytomas or multifocal glioma * no tumors originating in the brainstem * no residual tumor within 10 mm of optic chiasm * no recurrent glioblastoma multiforme patient characteristics: age: * not specified performance status: * zubrod 0-1 life expectancy: * not specified hematopoietic: * hemoglobin greater than 9 g/dl * absolute neutrophil count greater than 1,500/mm\^3 * platelet count greater than 100,000/mm\^3 hepatic: * bilirubin less than 2.0 mg/dl * serum glutamate pyruvate transaminase (sgpt) or serum glutamate oxaloacetate transaminase (sgot) less than 2 times normal renal: * creatinine less than 1.8 mg/dl * blood urea nitrogen (bun) less than 30 mg/dl pulmonary: * chest x-ray normal or * diffusion capacity of lung for carbon monoxide (dlco) greater than 60% predicted other: * not pregnant or nursing * negative pregnancy test * fertile patients must use effective contraception * neurologic functional status 0-3 * no other prior malignancy within the past 5 years except carcinoma in situ of the cervix or bladder, ductal carcinoma in situ of the breast, or nonmelanomatous skin cancer prior concurrent therapy: biologic therapy: * not specified chemotherapy: * not specified endocrine therapy: * concurrent steroids allowed radiotherapy: * not specified surgery: * see disease characteristics other: * concurrent anticonvulsants allowed

Keywords: adult glioblastoma adult giant cell glioblastoma adult gliosarcoma