Chemotherapy Followed by Radiation Therapy in Treating Adults With Supratentorial Glioma
Chemotherapy Followed by Radiation Therapy in Treating Adults With Supratentorial Glioma
RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so
 they stop growing or die. Radiation therapy uses high-energy x-rays to damage tumor cells.
 Combining radiation therapy with chemotherapy may kill more tumor cells.

 PURPOSE: Phase II trial to study the effectiveness of procarbazine, lomustine, and
 vincristine followed by radiation therapy in treating adults who have supratentorial glioma.
OBJECTIVES: I. Estimate the response rate of patients with newly diagnosed supratentorial
 low-grade glioma following neoadjuvant chemotherapy with PCV
 (procarbazine/lomustine/vincristine). II. Describe the toxicity of PCV. III. Determine the
 incidence of disease progression in these patients during PCV treatment.

 OUTLINE: The following acronyms are used: CCNU Lomustine, NSC-79037 PCB Procarbazine,
 NSC-77213 PCV PCB/CCNU/VCR VCR Vincristine, NSC-67574 3-Drug Combination Chemotherapy
 Followed by Radiotherapy. PCV; followed by external-beam cranial irradiation using at least 6
 MV photons.
DISEASE CHARACTERISTICS: Histologically confirmed supratentorial * grade I/II glioma,
 including: Diffuse fibrillary astrocytoma No pilocytic astrocytoma No mixed tumor with
 ependymoma elements * Supratentorial sites include: Frontal, temporal, parietal, or
 occipital lobes Thalamus, basal ganglia, or midbrain Lateral or third ventricles Pons,
 medulla, or optic chiasm tumors allowed only if secondary to eligible tumor More than 1
 separate tumor allowed Diagnosis based on surgical biopsy or subtotal resection Measurable
 or evaluable disease on T2-weighted MRI required

 PATIENT CHARACTERISTICS: Age: 18 and over Performance status: ECOG 0-2 Hematopoietic: WBC
 greater than 3,500/mm3 Platelet count greater than 130,000/mm3 Hemoglobin greater than 9
 g/dL Hepatic: Bilirubin less than 2 times upper limit of normal (ULN) AST less than 2 times
 ULN Alkaline phosphatase less than 2 times ULN Renal: Creatinine less than 1.5 times ULN
 Other: No active or uncontrolled infection No second malignancy within 3 years except:
 Nonmelanomatous skin cancer In situ cervical cancer No pregnant or nursing women Negative
 pregnancy test required within 7 days prior to entry Effective contraception required of
 fertile patients

 PRIOR CONCURRENT THERAPY: Biologic therapy: Not specified Chemotherapy: No prior
 chemotherapy Endocrine therapy: At least 1 week since prior steroids OR Stable steroid dose
 for at least 1 week prior to study Radiotherapy: No prior cranial or head and neck
 irradiation Surgery: See Disease Characteristics