Chemotherapy and Radiation Therapy for the Treatment of IDH Wildtype Gliomas or Non-histological (Molecular) Glioblastomas

Exclusion Criteria

• •Definitive clinical or radiologic evidence of metastatic disease; if applicable
• •Prior invasive malignancy (except non-melanomatous skin cancer) unless disease free for a minimum of 3 years. (For example, carcinoma in situ of the breast, oral cavity or cervix are permissible)
• •Prior cranial radiotherapy or radiotherapy to the head and neck where potential field overlaps would exist
• •Prior chemotherapy or radiotherapy for any brain tumor
• •Histologic diagnosis of gliosarcoma World Health Organization (WHO grade IV) or pilocytic astrocytoma (WHO grade I)
• •Multicentric glioblastoma
• •Leptomeningeal disease
• •Inability to undergo MRI with and without contrast
• •Severe, active co-morbidity defined as follows:
• •* Unstable angina or congestive heart failure requiring hospitalization within 6 months prior to enrollment
• •* Transmural myocardial infarction within the last 6 months prior to registration. Evidence of recent myocardial infarction or ischemia by the findings of S-T elevations of \>= 2 mm using the analysis of an electrocardiogram (EKG) performed within 28 days prior to registration. (Note: EKG to be performed only if clinical suspicion of cardiac issue)
• •• New York Heart Association grade II or greater congestive heart failure requiring hospitalization within 12 months prior to registration
• •* Serious and inadequately controlled arrhythmia at step 2 registration
• •* Serious or non-healing wound, ulcer or bone fracture or history of abdominal fistula, intra-abdominal abscess requiring major surgical procedure, open biopsy or significant traumatic injury within 28 days prior to registration, with the exception of the craniotomy for surgical resection
• •* Acute bacterial or fungal infection requiring intravenous antibiotics at the time of registration
• •* Hepatic insufficiency resulting in clinical jaundice and/or coagulation defects; note, however, that laboratory tests for coagulation parameters are not required for entry into this protocol
• •* Chronic obstructive pulmonary disease exacerbation or other respiratory illness requiring hospitalization or precluding study therapy at the time of registration
• •* Human immunodeficiency virus (HIV) positive with CD4 count \< 200 cells/microliter. Acquired immune deficiency syndrome (AIDS) based upon current Centers for Disease Control and Prevention (CDC) definition; note, however, that HIV testing is not required for entry into this protocol. The need to exclude patients with AIDS from this protocol is because the treatments involved in this protocol may be significantly immunosuppressive with potentially fatal outcomes in patients already immunosuppressed
• •Any other severe immunocompromised condition
• •Active connective tissue disorders, such as lupus or scleroderma that in the opinion of the treating physician may put the patient at high risk for radiation toxicity
• •End-stage renal disease (i.e., on dialysis or dialysis has been recommended)
• •Any other major medical illnesses or psychiatric treatments that in the investigator's opinion will prevent administration or completion of protocol therapy