Combination Chemotherapy Plus Radiation Therapy in Treating Patients With Anaplastic Astrocytoma
Combination Chemotherapy Plus Radiation Therapy in Treating Patients With Anaplastic Astrocytoma
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 more than one drug with radiation therapy may kill more tumor cells.

 PURPOSE: Phase II trial to study the effectiveness of combination chemotherapy plus radiation
 therapy in treating patients who have newly diagnosed anaplastic astrocytoma.
OBJECTIVES: I. Determine the efficacy of carmustine, cisplatin, and etoposide given prior to
 and during radiotherapy in patients with anaplastic astrocytoma. II. Assess the toxic effects
 associated with this regimen in these patients. III. Evaluate this regimen in terms of
 fatigue, depression, excessive daytime somnolence, and quality of life in these patients.

 OUTLINE: Patients receive carmustine IV over 1 hour on days 1-3, oral etoposide on days 1-21
 and 29-49, and cisplatin IV over 1-2 hours on days 1-3 and 29-31. Treatment repeats every 8
 weeks for 3 courses. Patients receive radiotherapy concurrently with the third course of
 chemotherapy. Quality of life is assessed every 4 months for 1 year, every 6 months for 4
 years, and then annually for 5 years. Patients are followed every 3 months for 5 years and
 then annually thereafter.

 PROJECTED ACCRUAL: A total of 28 patients will be accrued for this study within 20 months.
DISEASE CHARACTERISTICS: Histologically confirmed, newly diagnosed, anaplastic astrocytoma
 No oligodendrogliomas or oligoastrocytomas

 PATIENT CHARACTERISTICS: Age: 18 and over Performance status: ECOG 0-2 Life expectancy: Not
 specified Hematopoietic: WBC at least 3500/mm3 Platelet count at least 130,000/mm3 Hepatic:
 Bilirubin no greater than 1.5 times upper limit of normal (ULN) SGOT no greater than 2
 times ULN Renal: Creatinine no greater than 0.5 mg/dL Other: Not pregnant or nursing
 Fertile patients must use effective contraception No uncontrolled infection No concurrent
 malignant disease or major medical problem except superficial skin cancers

 PRIOR CONCURRENT THERAPY: Biologic therapy: Not specified Chemotherapy: At least 5 years
 since prior chemotherapy Endocrine therapy: Concurrent corticosteroids allowed
 Radiotherapy: At least 5 years since prior radiotherapy Surgery: Not specified