Sistema de Salut de Catalunya
Institut Català de la Salut
[Chavaz L] Department of Pediatrics, Gynecology and Obstetrics, Division of Pediatric Hematology and Oncology, University Hospital of Geneva, Geneva, Switzerland. Cansearch Research Platform for Pediatric Oncology and Hematology, Faculty of Medicine, Department of Pediatrics, Gynecology and Obstetrics, University of Geneva, Geneva, Switzerland. [Janssens GO] Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, Netherlands. Princess Maxima Center for Pediatric Oncology, Utrecht, Netherlands. [Bolle S] Department of Radiation Oncology, Gustave Roussy, Paris Saclay University, Villejuif, France. [Mandeville H] Department of Radiotherapy, The Royal Marsden Hospital and Institute of Cancer Research, Sutton, United Kingdom. [Ramos-Albiac M] Servei d’Oncologia Radioteràpica, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Van Beek K] Department of Radiation Oncology, University Hospitals Leuven, Leuven, Belgium
Vall d'Hebron Barcelona Hospital Campus
2023-01-10T08:19:19Z
2023-01-10T08:19:19Z
2022-06-22
Adolescent; Diffuse intrinsic pontine glioma; Radiotherapy
Adolescente; Glioma pontino intrínseco difuso; Radioterapia
Adolescent; Glioma pontí intrínsec difús; Radioteràpia
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 re-irradiation (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 two-thirds 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.
This work was supported in part by Deutsche Kinderkrebsstiftung.
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Avaluació de resultats (Assistència sanitària); Gliomes; Càncer - Radioteràpia; DISEASES::Neoplasms::Neoplasms by Histologic Type::Neoplasms, Germ Cell and Embryonal::Neuroectodermal Tumors::Neoplasms, Neuroepithelial::Glioma; Other subheadings::Other subheadings::Other subheadings::/radiotherapy; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Prognosis::Treatment Outcome; ENFERMEDADES::neoplasias::neoplasias por tipo histológico::neoplasias de células germinales y embrionarias::tumores neuroectodérmicos::neoplasias neuroepiteliales::glioma; Otros calificadores::Otros calificadores::Otros calificadores::/radioterapia; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::pronóstico::resultado del tratamiento
Frontiers Media
Frontiers in Oncology;12
https://doi.org/10.3389/fonc.2022.926196
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
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