Efficacy of Hypofractionated XRT w/Bev. + Temozolomide for Recurrent Gliomas

Inclusion Criteria

• •Patients must have histologically confirmed diagnosis of glioblastoma multiforme (GBM) or anaplastic glioma, World Health Organization (WHO) grade 3 or 4
• •* Patients must have measurable or non-measurable (evaluable) disease recurrence
• •* Recurrence must be documented based on a combination of clinical and imaging parameters, consistent with routine clinical practice, with or without histologic confirmation
• •* Patients may have had any number of relapses and be eligible for the study
• •* Patients must have been previously treated with radiation therapy and temozolomide (bevacizumab-naïve - Groups 1 and 3) or radiation therapy, temozolomide and bevacizumab (bevacizumab-exposed -Groups 2 and 4); therapy with these agents may be given together or sequentially in the past
• •* All patients may have had prior surgery, chemotherapy, and radiation therapy; prior biologic therapy is permitted only for bevacizumab-exposed patients (Groups 2 and 4); prior treatment with Gliadel is permitted for all groups
• •* For bevacizumab-naïve patients (Groups 1 and 3) a minimum of 6 months must have elapsed since completion of radiation therapy for study entry, and there is no minimum time since completion of last chemotherapy; for bevacizumab-exposed patients (Groups 2 and 4) no minimum time since completion of last radiation therapy, biologic agents, or chemotherapy will be required for study entry
• •* Patients must have an ECOG performance status of =\< 2
• •* Hemoglobin \>= 10
• •* Platelets \>= 100,000/mm\^3
• •* Absolute neutrophil count \>= 1500/mm\^3
• •* Bilirubin =\< 1.5 x upper limit of normal range (ULN)
• •* Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =\< 3 x ULN
• •* Blood urea nitrogen (BUN) =\< 1.5 x ULN
• •* Creatinine =\< 1.5 x ULN
• •* Urine protein/creatinine ratio should be =\< 1
• •* Patients' baseline blood pressure must be adequately controlled with or without antihypertensive medications prior to enrollment (systolic \< 140 mmHg, diastolic \< 90 mmHg)
• •* Patients must have a baseline evaluation including history and physical examination with neurological evaluation and magnetic resonance imaging (MRI) of the brain (with and without gadolinium-based contrast), all completed within 30 days prior to initiation of treatment
• •* Female patients of child-bearing potential must have a negative pregnancy test within 14 days prior to enrollment on study; child-bearing potential is defined as any female (regardless of sexual orientation, having undergone a tubal ligation, or remaining celibate by choice) who meets one of the following criteria:
• •* Has not undergone a hysterectomy or bilateral oophorectomy
• •* Or has not been naturally postmenopausal for at least 12 consecutive months (i.e. has had menses at any time in the preceding consecutive 12 months)
• •* Females of child-bearing potential and sexually-active males must consent to follow acceptable birth control methods to avoid contraception while on treatment
• •* All subjects must have given signed, informed consent prior to registration on study
• •* Patients previously treated outside of Northwestern must have their pathology slides sent to Northwestern for review and confirmation - NOTE: a copy of the pathology report is sufficient for registration