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