Brain and Central Nervous System Tumors Clinical Trial
Official title:
A Trial Of Radioimmunotherapy, Reduced-Dose External Beam Craniospinal Radiation Therapy With IMRT Boost, And Chemotherapy For Patients With Standard-Risk Medulloblastoma
RATIONALE: Radioimmunotherapy uses radiolabeled monoclonal antibodies to locate tumor cells
and deliver radioactive tumor-killing substances to them without harming normal cells.
Radiation therapy uses high-energy x-rays to damage tumor cells. Drugs used in chemotherapy
use different ways to stop tumor cells from dividing so they stop growing or die. Combining
intrathecal radioimmunotherapy and radiation therapy with combination chemotherapy may kill
any tumor cells remaining after surgery.
PURPOSE: Phase II trial to study the effectiveness of combining intrathecal
radioimmunotherapy and radiation therapy with combination chemotherapy in treating patients
who have undergone surgery for medulloblastoma.
OBJECTIVES:
- Determine the feasibility of combining post-operative intrathecal radioimmunotherapy,
craniospinal radiotherapy with intensity-modulated radiotherapy boost, and chemotherapy
in patients with standard-risk medulloblastoma.
- Determine whether this regimen can maintain or exceed the current progression-free
survival rate while decreasing long-term serious morbidity in these patients.
- Determine the long-term morbidities, most specifically neuropsychological,
neuroendocrine, audiometric, and growth outcomes, in patients treated with this regimen.
OUTLINE:
- Radioimmunotherapy: Patients receive intrathecal iodine I 131 monoclonal antibody 3F8 on
days 1 and 8.
- Radiotherapy: Beginning as soon as possible after radioimmunotherapy, patients undergo
external-beam and intensity-modulated radiotherapy 5 days a week for 6 weeks.
- Chemotherapy: Patients receive vincristine IV once weekly for 8 weeks concurrently with
radiotherapy. Beginning about 6 weeks after completion of radiotherapy (4 weeks after
vincristine), patients receive cisplatin IV over 6 hours and oral lomustine on day 0 and
vincristine IV on days 0, 7, and 14. Treatment repeats every 6 weeks for up to 8 courses
in the absence of disease progression or unacceptable toxicity.
After completion of study treatment, patients are followed periodically.
PROJECTED ACCRUAL: A total of 6-20 patients will be accrued for this study within 3.2 years.
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