Radiation Therapy Followed by Carmustine in Treating Patients Who Have Supratentorial Glioblastoma Multiforme
Radiation Therapy Followed by Carmustine in Treating Patients Who Have Supratentorial Glioblastoma Multiforme
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.
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