The Treatment of One or Two Supratentorial Brain Metastases With Surgical Resection and BCNU-Polymer Wafers

Inclusion Criteria

DISEASE CHARACTERISTICS:

- Supratentorial brain metastases for which surgery is recommended

- Solitary, unilateral, intracranial mass consistent with metastasis on MRI scan
OR

- Two brain lesions consistent with metastases on MRI scan

- Lesions must be accessible through a single craniotomy

- Metastatic lesions clearly distinct from tumor bed of any benign lesions

- Intraoperative frozen section diagnosis of metastatic tumor from CNS lesion

- No prior malignant intracranial neoplasm

- No lesion(s) in the brainstem

- No open communication of the resection cavity with the ventricle following resection

PATIENT CHARACTERISTICS:

Age

- 18 and over

Performance status

- Karnofsky 60-100%

Life expectancy

- At least 3 months

Hematopoietic

- No concurrent hematologic disorders

Hepatic

- No concurrent hepatic disease

Renal

- No concurrent renal disease

Cardiovascular

- No concurrent cardiac disease

Pulmonary

- No concurrent pulmonary disorders

Other

- Not pregnant or nursing

- Fertile patients must use effective contraception

- Mini mental score at least 15

- No known hypersensitivity to carmustine or Gliadel wafers

- No other serious concurrent medical illness or infection

PRIOR CONCURRENT THERAPY:

Biologic therapy

- Not specified

Chemotherapy

- Not specified

Endocrine therapy

- Not specified

Radiotherapy

- No prior cranial irradiation

Surgery

- See Disease Characteristics

- No prior surgery involving brain metastases or primary brain tumor(s) (except for
benign intracranial lesions such as pituitary adenoma, meningioma, or schwannoma)

Other

- Concurrent systemic therapy allowed