Brain and Central Nervous System Tumors Clinical Trial
Official title:
Phase I/II Radiation Dose Escalation Study Applying Conformal Radiation Therapy in Supratentorial Glioblastoma Multiforme
RATIONALE: Radiation therapy uses high-energy x-rays to damage tumor cells. Computer systems
that allow doctors to create a 3-dimensional picture of the tumor in order to plan treatment
may result in more effective radiation therapy. Drugs used in chemotherapy use different
ways to stop tumor cells from dividing so they stop growing or die. Combining radiation
therapy with chemotherapy may kill more tumor cells.
PURPOSE: Phase I/II trial to study the effectiveness of radiation therapy that has been
planned with a computer plus chemotherapy in treating patients who have glioblastoma
multiforme.
OBJECTIVES:
- Determine the feasibility and toxicity of escalating doses of conformal radiotherapy
planned with 3-D treatment planning plus carmustine in patients with glioblastoma
multiforme.
- Determine dose/volume and dose/anatomic characteristics that influence
radiotherapy-induced CNS (central nervous system) toxicity.
- Evaluate local control, survival, and failure patterns of these patients treated with
high doses of conformal radiotherapy to gross disease.
- Correlate changes on cross-sectional diagnostic MRI imaging studies to clinical or
biologic endpoints.
OUTLINE: This is a dose-escalation study. Patients are stratified according to the planned
target volume, i.e., gross residual tumor plus 3 mm (less than 75 cc vs at least 75 cc).
Patients undergo radiotherapy over 15-30 minutes daily 5 days a week for 6-8 weeks. After 46
Gy of radiotherapy have been administered, patients undergo radiotherapy field reduction and
are accrued into one of four dose levels. (Dose level 1 closed to accrual 1/16/01) All
patients receive at least 33 radiation treatments. Each patient is evaluated for acute
dose-limiting toxicity for 90 days from start of therapy.
Patients also receive carmustine IV over 1-2 hours daily on days 1-3 for the first week of
radiotherapy. Treatment repeats every 8 weeks for up to 6 courses.
Patients are followed every 4 months for 2 years, every 6 months for 1 year, and then
annually thereafter.
PROJECTED ACCRUAL: A total of 40 patients (20 per arm) will be accrued for this study within
at least 5 months.
;
Primary Purpose: Treatment
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