Radiation Therapy in Treating Young Patients With Gliomas

Inclusion Criteria

• •DISEASE CHARACTERISTICS:
• •Histologically confirmed\* low-grade glioma, including any of the following:
• •* Juvenile pilocytic astrocytoma (JPA) or pleomorphic JPA
• •* Diffuse astrocytoma, including any of the following subtypes:
• •* Fibrillary astrocytoma
• •* Gemistocytic astrocytoma
• •* Subependymal giant cell astrocytoma
• •* Pleomorphic xanthoastrocytoma
• •* Low-grade oligoastrocytoma
• •* Low-grade oligodendroglioma
• •* Low-grade glioma not otherwise specified NOTE: \*Patients with chiasmatic lesions who have contiguous extension of tumor into other regions of the visual pathway by CT scan or MRI are eligible without histopathologic confirmation; repeat biopsy required for patients with recurrent tumors that enhance but whose initial tumor did not
• •Measurable disease by radiography
• •Meets any of the following criteria:
• •* Progressive nonresectable disease
• •* Any location in the brain
• •* Patients with a less than gross total resection are eligible provided they are symptomatic from their tumor OR the risk from neurologic impairment with progression is high enough to warrant immediate treatment
• •* Has undergone biopsy only
• •Must have received ≥ 1 course of prior chemotherapy (for patients \< 10 years of age)
• •* Prior chemotherapy optional (for patients ≥ 10 years of age)
• •No type-1 neurofibromatosis
• •No evidence of leptomeningeal dissemination
• •PATIENT CHARACTERISTICS:
• •Age
• •3 to 20
• •Performance status
• •ECOG 0-2 OR
• •Karnofsky 50-100% (for patients \> 16 years of age) OR
• •Lansky 50-100% (for patients ≤ 16 years of age)
• •Life expectancy
• •At least 1 year
• •Hematopoietic
• •Absolute neutrophil count ≥ 1,000/mm\^3
• •Platelet count ≥ 100,000/mm\^3 (transfusion independent)
• •Hemoglobin ≥ 10.0 g/dL (transfusions allowed)
• •Hepatic
• •Not specified
• •Renal
• •Not specified
• •Other
• •Not pregnant
• •Negative pregnancy test
• •Fertile patients must use effective contraception
• •Not in status epilepticus, coma, or requiring assisted ventilation prior to study entry
• •Patients with a seizure disorder are eligible provided they are on anticonvulsants AND disease is well controlled
• •PRIOR CONCURRENT THERAPY:
• •Biologic therapy
• •Not specified
• •Chemotherapy
• •See Disease Characteristics
• •Recovered from prior chemotherapy
• •No concurrent chemotherapy
• •Endocrine therapy
• •Concurrent dexamethasone allowed provided patient has been on a stable dose for ≥ 2 weeks prior to study entry
• •Concurrent dexamethasone allowed for symptoms of increased intracranial pressure
• •Radiotherapy
• •No prior radiotherapy
• •Surgery
• •See Disease Characteristics
• •Other
• •No other concurrent anticancer therapy