Radiation Therapy, Temozolomide, and Irinotecan in Treating Patients With Newly Diagnosed Glioblastoma Multiforme

DISEASE CHARACTERISTICS:

• Histologically confirmed newly diagnosed supratentorial glioblastoma multiforme by surgical biopsy or excision

  • No gliomas graded less than glioblastoma multiforme
  • No recurrent malignant gliomas
• No tumor foci below the tentorium or beyond the cranial vault
• Study therapy must begin ≤ 5 weeks after surgery

PATIENT CHARACTERISTICS:

Age

• 18 and over

Performance status

• Zubrod 0-1

Life expectancy

• At least 8 weeks

Hematopoietic

• Absolute neutrophil count ≥ 1,500/mm^3
• Platelet count ≥ 100,000/mm^3
• Hemoglobin ≥ 10 g/dL*
• Hematocrit ≥ 30%* NOTE: *Transfusion allowed

Hepatic

• Bilirubin ≤ 0.5 mg/dL
• ALT or AST ≤ 2 times upper limit of normal

Renal

• Creatinine ≤ 1.5 mg/dL
• BUN ≤ 25 mg/dL

Other

• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective double-barrier contraception during and for 2 months after study participation
• No AIDS
• No other malignancy within the past 5 years except nonmelanoma skin cancer or carcinoma in situ of the cervix or bladder
• No other major medical illness or psychiatric impairment that would preclude study participation

PRIOR CONCURRENT THERAPY:

Biologic therapy

• No concurrent sargramostim (GM-CSF)

Chemotherapy

• No other concurrent chemotherapy

Endocrine therapy

• Concurrent steroid therapy allowed provided patient is on a stable or decreasing dose for at least 2 weeks before study entry

Radiotherapy

• No prior radiotherapy to the head or neck resulting in overlap of radiotherapy fields

  • Prior radiotherapy for stage T1 glottic cancer allowed

Surgery

• See Disease Characteristics
• Recovered from prior surgery

Other

• No enzyme-inducing antiepileptic drugs within 14 days before the initiation of irinotecan

  • Concurrent non-enzyme-inducing antiepileptic drugs allowed