Topotecan, G-CSF, and Radiation Therapy in Treating Young Patients With Newly Diagnosed Brain Stem Glioma

You may be eligible if

• DISEASE CHARACTERISTICS:
• Diagnosis of intrinsic pontine brain stem glioma within the past 30 days
• * Histologic confirmation not required provided the tumor has a pontine epicenter AND exhibits diffuse (rather than focal) involvement of ≥ 2/3 of the pons with or without extension to the adjacent medulla or midbrain\* NOTE: \*Brain stem tumors that do not meet these criteria must be histologically confirmed as grade III or IV malignant glioma
• Measurable disease by radiographic imaging
• * Post-operative MRI required within the past 30 days if patient had a biopsy or surgical resection
• No disseminated disease
• No neurofibromatosis type 1
• PATIENT CHARACTERISTICS:
• Age
• 3 to 21 at diagnosis
• Performance status
• Lansky 50-100% OR
• Karnofsky 50-100%
• Life expectancy
• At least 8 weeks
• Hematopoietic
• Absolute neutrophil count ≥ 1,000/mm\^3
• Platelet count ≥ 100,000/mm\^3 (transfusion independent)
• Hemoglobin ≥ 10.0 g/dL (transfusion allowed)
• Hepatic
• Bilirubin ≤ 1.5 times upper limit of normal (ULN)
• ALT \< 2.5 times ULN
• Renal
• Creatinine clearance or radioisotope glomerular filtration rate ≥ 70 mL/min OR
• Creatinine based on age as follows:
• * No greater than 0.8 mg/dL (for patients ≤ 5 years of age)
• * No greater than 1.0 mg/dL (for patients 6 to 10 years of age)
• * No greater than 1.2 mg/dL (for patients 11 to 15 years of age)
• * No greater than 1.5 mg/dL (for patients over 15 years of age)
• Other
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception
• Not severely somnolent or comatose
• * Central cortical neurotoxicity scale \< grade 3
• PRIOR CONCURRENT THERAPY:
• Biologic therapy
• No concurrent immunomodulating agents
• Chemotherapy
• No other concurrent anticancer chemotherapy
• Endocrine therapy
• Concurrent corticosteroids allowed for neurological deficits related to the tumor
• Radiotherapy
• No prior radiotherapy
• Surgery
• See Disease Characteristics
• Prior biopsy or surgical resection for malignant brain stem glioma allowed
• Other
• No other prior therapy for malignant brain stem glioma