Combination Chemotherapy Plus Radiation Therapy in Treating Patients With 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