Paediatrics Publications
Title
Reirradiation in patients with diffuse intrinsic pontine gliomas: The Canadian experience.
Document Type
Article
Publication Date
6-1-2018
Journal
Pediatric Blood & Cancer
Volume
65
Issue
6
First Page
26988
Last Page
26988
URL with Digital Object Identifier
https://doi.org/10.1002/pbc.26988
Abstract
Objective
Clinical trials have failed to demonstrate a survival benefit of adjuvant chemotherapy in diffuse intrinsic pontine gliomas (DIPG). Radiation therapy (RT) is the only effective treatment thus far and reirradiation (rRT) has become an option at the time of progression. The aim of this study was to review the Canadian experience of DIPG rRT with a focus on the safety and possible efficacy of this approach.
Method
We retrospectively reviewed the demographic, clinical, and RT data of patients with DIPG treated in Canada with rRT.
Results
Since January 2011, we identified 16 patients with progressive DIPG who received rRT. Median time from diagnosis to progression was 10.5 months (range, 4-37 months). rRT was given focally in 14 patients at a dose ranging from 21.6 to 36 Gy. rRT was well tolerated by all children but one. All but three patients showed neurological improvement. With a median follow-up from original diagnosis of 19.2 months, all patients died, with a median time from rRT to death of 6.48 months (range, 3.83-13.26 months). When compared to a historic cohort of 46 consecutive patients, the median time from progression to death was 92 days in the non-reirradiated patients versus 218 days in the reirradiated ones (P = 0.0001).
Conclusion
In this limited experience, rRT was safe and feasible in patients with progressive DIPG, providing neurological improvement and a prolonged life span in most patients. Prospective Canadian rRT protocols are ongoing to further assess the benefit of this approach, including quality of life assessment.
Notes
Article available at Pediatric Blood & Cancer, Vol. 65(6)
https://doi.org/10.1002/pbc.26988
© 2018 Wiley Periodicals, Inc.