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