Purpose: The aim of this study is to investigate the spectrum of neurological triad
improvement in patients with diffuse intrinsic pontine glioma (DIPG) treated by reirradiation
(re-RT) at first progression.
Methods: We carried out a re-analysis of the SIOP-E retrospective DIPG cohort by
investigating the clinical benefits after re-RT with a focus on the neurological triad (cranial
nerve deficits, ataxia, and long tract signs). Patients were categorized as “responding” or
“non-responding” to re-RT. To assess the interdependence between patients’
characteristics and clinical benefits, we used a chi-square or Fisher’s exact test.
Survival according to clinical response to re-RT was calculated by the Kaplan–Meier
method.
Results: As earlier reported, 77% (n = 24/31) of patients had any clinical benefit after re-
RT. Among 25/31 well-documented patients, 44% (n = 11/25) had improvement in cranial
nerve palsies, 40% (n = 10/25) had improvement in long-tract signs, and 44% (11/25) had improvement in cerebellar signs. Clinical benefits were observed in at least 1, 2, or 3 out of
3 symptoms of the DIPG triad, in 64%, 40%, and 24%, respectively. Patients irradiated
with a dose ≥20 Gy versus <20 Gy may improve slightly better with regard to ataxia (67%
versus 23%; p-value = 0.028). The survival from the start of re-RT to death was not
different between responding and non-responding DIPG patients (p-value = 0.871).
Conclusion: A median re-irradiation dose of 20 Gy provides a neurological benefit in twothirds
of patients with an improvement of at least one symptom of the triad. DIPG patients
receiving ≥20 Gy appear to improve slightly better with regard to ataxia; however, we need
more data to determine whether dose escalation up to 30 Gy provides additional benefits.
| Identifer | oai:union.ndltd.org:DRESDEN/oai:qucosa:de:qucosa:87689 |
| Date | 26 October 2023 |
| Creators | Chavaz, Lara, Janssens, Geert O., Bolle, Stephanie, Mandeville, Henry, Ramos-Albiac, Monica, van Beek, Karen, Benghiat, Helen, Hoeben, Bianca, Morales La Madrid, Andres, Seidel, Clemens, Kortmann, Rolf-Dieter, Hargreave, Darren, Gandola, Lorenza, Pecori, Emilia, van Vuurden, Dannis G., Biassoni, Veronica, Massimino, Maura, Kramm, Christof M., van Bueren, Andre O. |
| Publisher | Frontiers Media S.A. |
| Source Sets | Hochschulschriftenserver (HSSS) der SLUB Dresden |
| Language | English |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, doc-type:article, info:eu-repo/semantics/article, doc-type:Text |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 926196 |
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