Brain and Central Nervous System Tumors Clinical Trial
Official title:
Phase III Intergroup Randomized Comparison of Radiation Alone vs. Pre-Radiation Chemotherapy for Pure and Mixed Anaplastic Oligodendrogliomas
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 chemotherapy with radiation therapy may kill more tumor cells.
PURPOSE: Randomized phase III trial to compare the effectiveness of radiation therapy with or
without chemotherapy in treating patients who have anaplastic oligodendroglioma.
OBJECTIVES:
- Compare the overall survival and time to tumor progression in patients with unifocal or
multifocal, supratentorial, pure or mixed anaplastic oligodendroglioma treated with
radiotherapy with or without procarbazine, lomustine, and vincristine (PCV).
- Compare the toxic effects of these 2 regimens in these patients.
- Compare the quality of life and neurologic function of patients treated with these 2
regimens.
OUTLINE: This is a randomized study. Patients are stratified by age (under 50 vs 50 and
over), Karnofsky performance status (60-70% vs 80-100%), and tumor grade (moderately vs
highly anaplastic). Within 8 weeks after diagnostic surgery, patients are randomized to 1 of
2 treatment arms.
- Arm I: Within 2 weeks after randomization, patients receive oral lomustine on day 1,
oral procarbazine on days 8-21, and vincristine IV on days 8 and 29 (PCV). Treatment
continues every 6 weeks for 4 courses in the absence of disease progression or
unacceptable toxicity. Beginning within 6 weeks after day 29 of course 4, patients
undergo radiotherapy 5 days a week for 5.6 weeks followed by boost radiotherapy 5 days a
week for 1 week.
- Arm II: Within 2 weeks after randomization, patients undergo radiotherapy as in arm I.
Quality of life is assessed at baseline; at time of CT or MRI scans during study; and every 3
months for 1 year, every 4 months for 1 year, every 6 months for 3 years, and then annually
thereafter after completion of study therapy.
Patients are followed every 3 months for 1 year, every 4 months for 1 year, every 6 months
for 3 years, and then annually thereafter.
PROJECTED ACCRUAL: A total of 292 patients (146 per arm) will be accrued for this study
within 5.4 years.
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