Arms |
Assigned Interventions |
Active Comparator:Arm A1 (control)
Patients undergo standard-dose photon irradiation using 3D-CRT or IMRT QD, 5 days a week for 23 fractions plus a boost of 7 additional fractions.
In all treatment arms, patients receive temozolomide PO QD on days 1-49 of radiation therapy. Beginning 4 weeks later, patients receive temozolomide PO QD on days 1-5. Treatment repeats every 28 days for up to 12 courses in the absence of disease progression or unacceptable toxicity.
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Other:laboratory biomarker analysis Correlative studies |
Experimental:Arm B (photon IMRT)
Patients undergo dose-escalated and -intensified photon IMRT QD, 5 days a week for a total of 30 fractions.
In all treatment arms, patients receive temozolomide PO QD on days 1-49 of radiation therapy. Beginning 4 weeks later, patients receive temozolomide PO QD on days 1-5. Treatment repeats every 28 days for up to 12 courses in the absence of disease progression or unacceptable toxicity.
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Radiation:intensity-modulated radiation therapy Undergo dose-escalated and -intensified photon IMRT |
Active Comparator:Arm A2 (control)
Patients undergo standard-dose photon irradiation using 3D-CRT or IMRT as in Arm A1.
In all treatment arms, patients receive temozolomide PO QD on days 1-49 of radiation therapy. Beginning 4 weeks later, patients receive temozolomide PO QD on days 1-5. Treatment repeats every 28 days for up to 12 courses in the absence of disease progression or unacceptable toxicity.
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Experimental:Arm C (proton beam radiation therapy)
Patients undergo dose-escalated and -intensified proton beam therapy QD, 5 days a week for a total of 30 fractions.
In all treatment arms, patients receive temozolomide PO QD on days 1-49 of radiation therapy. Beginning 4 weeks later, patients receive temozolomide PO QD on days 1-5. Treatment repeats every 28 days for up to 12 courses in the absence of disease progression or unacceptable toxicity.
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Radiation:proton beam radiation therapy Undergo dose-escalated and -intensified proton beam radiation therapy |