Radiation Therapy or Temozolomide in Treating Patients With Gliomas
Brain and Central Nervous System Tumors
About this trial
This is an interventional treatment trial for Brain and Central Nervous System Tumors focused on measuring adult oligodendroglioma, adult diffuse astrocytoma, adult mixed glioma
Eligibility Criteria
DISEASE CHARACTERISTICS: Histologically confirmed low-grade glioma, including any of the following types: Astrocytoma (gemistocytic, fibrillary, or protoplasmatic) Oligoastrocytoma Oligodendroglioma WHO grade II disease Supratentorial tumor location only RTOG neurological function 0-3 Not a candidate for surgical treatment alone Requires treatment, as determined by ≥ 1 of the following criteria: Age ≥ 40 years Radiologically-proven progressive lesion New or worsening neurological symptoms other than seizures only (e.g., focal deficits, signs of increased intracranial pressure, or mental deficits) Intractable seizures, defined by both of the following criteria: Experiences persistent seizures that interfere with everyday life activities except driving a car Failed 3 anti-epileptic drug regimens, including ≥ 1 combination regimen Tumor material (paraffin-embedded) or histopathologic slides available PATIENT CHARACTERISTICS: Age 18 and over Performance status WHO 0-2 Life expectancy Not specified Hematopoietic Absolute neutrophil count ≥ 1,500/mm^3 Platelet count ≥ 100,000/mm^3 Hepatic No chronic hepatitis B or C infection Bilirubin ≤ 1.5 times upper limit of normal (ULN) AST or ALT ≤ 2.5 times ULN Alkaline phosphatase ≤ 2.5 times ULN Renal Creatinine ≤ 1.5 times ULN Other Not pregnant or nursing Fertile patients must use effective contraception during and for 6 months after completion of study treatment No known HIV positivity No other serious medical condition No other prior or concurrent malignancy except surgically cured carcinoma in situ of the cervix or nonmelanoma skin cancer No psychological, familial, sociological, or geographical condition that would preclude study participation No medical condition that would preclude receiving oral medication (e.g., frequent vomiting or partial bowel obstruction) PRIOR CONCURRENT THERAPY: Biologic therapy No concurrent growth factors for elevating absolute neutrophil counts for the purpose of temozolomide administration No concurrent epoetin alfa No concurrent immunotherapy or biologic therapy Chemotherapy No prior chemotherapy No other concurrent chemotherapy, including adjuvant chemotherapy for patients randomized to undergo radiotherapy Endocrine therapy Not specified Radiotherapy No prior radiotherapy to the brain No concurrent integrated boost with intensity-modulated radiotherapy Surgery Recovered from prior surgery No concurrent surgical tumor debulking Other No prior randomization to this study No other concurrent investigational drugs No concurrent regular use of agents known to be radiosensitizers or radioprotectors (e.g., cyclooxygenase-2 inhibitors, thalidomide, or amifostine) during study radiotherapy Occasional use of nonsteroidal anti-inflammatory drugs for pain allowed
Sites / Locations
- Prince of Wales Private Hospital
- Royal North Shore Hospital
- Sydney Cancer Centre at Royal Prince Alfred Hospital
- Calvary Mater Newcastle
- Royal Brisbane and Women's Hospital
- Princess Alexandra Hospital
- Mater Adult Hospital
- Peter MacCallum Cancer Centre
- Austin and Repatriation Medical Centre
- Alfred Hospital
- Sir Charles Gairdner Hospital - Nedlands
- Liverpool Hospital
- Medical University Vienna - General Hospital AKH
- Hopital Universitaire Erasme
- Universitair Ziekenhuis Brussel
- U.Z. Leuven - Campus Gasthuisberg
- Tom Baker Cancer Centre - Calgary
- CancerCare Manitoba
- Saint John Regional Hospital
- Nova Scotia Cancer Centre
- Margaret and Charles Juravinski Cancer Centre
- London Regional Cancer Program at London Health Sciences Centre
- Edmond Odette Cancer Centre at Sunnybrook
- Princess Margaret Hospital
- Hopital Notre-Dame du CHUM
- Mcgill University Health Centre - Gerald Bronfman Centre - Dept Of Oncology
- Allan Blair Cancer Centre at Pasqua Hospital
- BC Cancer Agency
- National Cancer Institute of Egypt
- CHU de Bordeaux - Groupe Hospitalier Saint-André - Hopital Saint-Andre
- Institut Bergonie
- CHU de Grenoble - Hopital de la Tronche
- CHU de la Timone
- Centre Regional Rene Gauducheau
- Assistance Publique - Hopitaux de Paris - La Pitie Salpetriere
- Centre Eugene Marquis
- Centre Paul Strauss
- Institut Claudius Regaud
- Gustave Roussy
- Universitatsklinikum Heidelberg
- Universitaetsklinikum Leipzig
- Universitaetskliniken Regensburg
- Universitaetsklinikum Tuebingen
- National Institute Of Neurosurgery
- Rambam Health Care Campus, Oncology Institute
- Ospedale Bellaria
- Ospedale San Raffaele
- Istituto Regina Elena / Istituti Fisioterapici Ospitalieri
- Azienda Sanitaria Ospedale San Giovanni Battista Molinette di Torino
- Centre Francois Baclesse
- Vrije Universiteit Medisch Centrum
- Academisch Medisch Centrum - Universiteit van Amsterdam
- Medisch Centrum Haaglanden - Westeinde
- University Medical Center Groningen
- Maastro Clinic - Maastricht Radiation Oncology
- Radboud University Medical Center Nijmegen
- Erasmus MC Cancer Institute - location Daniel den Hoed
- Dr. Bernard Verbeeten Instituut
- Canterbury Health Laboratories
- Instituto Portugues de Oncologia de Francisco Gentil - Centro Regional de Oncologia de Lisboa, SA
- National University of Singapore
- ICO Badalona - Hospital Germans Trias i Pujol (Institut Catala D'Oncologia)
- Hospital General Vall D'Hebron
- Hospital Clinic de Barcelona
- Hospital Clinico Universitario de Barcelona
- ICO Girona - Hospital Doctor Josep Trueta (Institut Catala D'Oncologia)
- ICO L'Hospitalet - Hospital Duran i Reynals (Institut Catala D'Oncologia)
- University Hospital of Linkoping
- Skane University Hospital
- Umea Universitet
- Uppsala University Hospital
- Oncology Institute of Southern Switzerland - Ospedale Regionale Bellinzona e Valli
- Centre Hospitalier Universitaire Vaudois - Lausanne
- UniversitaetsSpital Zurich
- University Hospitals Bristol NHS Foundation Trust - Bristol Haematology And Oncology Centre
- Clatterbridge Centre for Oncology
- Addenbrooke's Hospital
- Leeds Cancer Centre at St. James's University Hospital
- University College Hospital
- Royal Marsden - London
- Christie Hospital
- James Cook University Hospital
- Cancer Research Centre at Weston Park Hospital
- Royal Marsden - Surrey
- Gloucestershire Hospital NHS Foundation Trust - Cheltenham General Hospital
- Western General Hospital
- Royal Free Hospital
- Oxford University Hospitals NHS Trust - Churchill Hospital
- Lancashire Teaching Hospitals NHS Foundation Trust - Royal Preston Hospital
Arms of the Study
Arm 1
Arm 2
Other
Experimental
radiotherapy
Temozolomide
Radiotherapy (control arm), 50.4 Gy, standard fractionation (28 x 1.8 Gy), conformal techniques
Temozolomide 75 mg/m2 daily x 21 days, q 28 days until progression or for max. 12 cycles (experimental arm)