Alper Kahvecioglu, Mustafa Cengiz, Guzide Burca Aydin, Mustafa Tezer Kutluk, Gokcen Coban Cifci, Gozde Yazici
{"title":"Re-irradiation in progressive diffuse infiltrative pontine glioma in children and young adults.","authors":"Alper Kahvecioglu, Mustafa Cengiz, Guzide Burca Aydin, Mustafa Tezer Kutluk, Gokcen Coban Cifci, Gozde Yazici","doi":"10.1007/s00066-025-02394-z","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to assess oncological outcomes in children and young adults with diffuse infiltrative pontine glioma (DIPG) who have progressed after initial radiotherapy (RT), with an emphasis on the role of re-irradiation.</p><p><strong>Methods: </strong>Data from 33 patients aged 25 years or younger with progressive disease after initial RT were retrospectively analyzed.</p><p><strong>Results: </strong>The median age at diagnosis was 8 years (range 4-24 years), and the median initial RT dose was 54 Gy (range 39-54 Gy). The median time between initial RT and progression was 8 months (range 3-40 months). In addition to systemic therapy, 15 patients (46%) received re-irradiation due to progression, with a median dose of 23.4 Gy (range 19.8-36 Gy), while 18 patients (54%) were treated with systemic therapy alone. In patients who received re-irradiation after progression, the 1‑year post-progression overall survival (OS) was significantly higher compared to those treated with systemic therapy alone (27% vs. 0%, p = 0.01). Among the 15 re-irradiated patients, 9 out of 12 with available data (75%) showed improvement in neurological symptoms following re-irradiation. No patient exhibited acute or late RT-related ≥ grade 3 toxicity.</p><p><strong>Conclusion: </strong>Palliative re-irradiation in children and young adults with progressive DIPG after initial RT provides an approximately 3‑month OS benefit and clinical improvement without significant toxicity and should be considered as a standard-of-care approach.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":""},"PeriodicalIF":2.7000,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Strahlentherapie und Onkologie","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00066-025-02394-z","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: This study aims to assess oncological outcomes in children and young adults with diffuse infiltrative pontine glioma (DIPG) who have progressed after initial radiotherapy (RT), with an emphasis on the role of re-irradiation.
Methods: Data from 33 patients aged 25 years or younger with progressive disease after initial RT were retrospectively analyzed.
Results: The median age at diagnosis was 8 years (range 4-24 years), and the median initial RT dose was 54 Gy (range 39-54 Gy). The median time between initial RT and progression was 8 months (range 3-40 months). In addition to systemic therapy, 15 patients (46%) received re-irradiation due to progression, with a median dose of 23.4 Gy (range 19.8-36 Gy), while 18 patients (54%) were treated with systemic therapy alone. In patients who received re-irradiation after progression, the 1‑year post-progression overall survival (OS) was significantly higher compared to those treated with systemic therapy alone (27% vs. 0%, p = 0.01). Among the 15 re-irradiated patients, 9 out of 12 with available data (75%) showed improvement in neurological symptoms following re-irradiation. No patient exhibited acute or late RT-related ≥ grade 3 toxicity.
Conclusion: Palliative re-irradiation in children and young adults with progressive DIPG after initial RT provides an approximately 3‑month OS benefit and clinical improvement without significant toxicity and should be considered as a standard-of-care approach.
期刊介绍:
Strahlentherapie und Onkologie, published monthly, is a scientific journal that covers all aspects of oncology with focus on radiooncology, radiation biology and radiation physics. The articles are not only of interest to radiooncologists but to all physicians interested in oncology, to radiation biologists and radiation physicists. The journal publishes original articles, review articles and case studies that are peer-reviewed. It includes scientific short communications as well as a literature review with annotated articles that inform the reader on new developments in the various disciplines concerned and hence allow for a sound overview on the latest results in radiooncology research.
Founded in 1912, Strahlentherapie und Onkologie is the oldest oncological journal in the world. Today, contributions are published in English and German. All articles have English summaries and legends. The journal is the official publication of several scientific radiooncological societies and publishes the relevant communications of these societies.