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. 2025 Sep;201(9):894-902.
doi: 10.1007/s00066-025-02394-z. Epub 2025 Mar 25.

Re-irradiation in progressive diffuse infiltrative pontine glioma in children and young adults

Alper Kahvecioglu  1 , Mustafa Cengiz  1 , Guzide Burca Aydin  2 , Mustafa Tezer Kutluk  2 , Gokcen Coban Cifci  3 , Gozde Yazici  4
Affiliations

Re-irradiation in progressive diffuse infiltrative pontine glioma in children and young adults

Alper Kahvecioglu et al. Strahlenther Onkol. 2025 Sep.

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.

Keywords: Brainstem glioma; Childhood brain tumors; Palliative radiotherapy; Progressive disease; Second course radiotherapy.

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Conflict of interest statement

Declarations. Conflict of interest: A. Kahvecioglu, M. Cengiz, G. Burca Aydin, M. Tezer Kutluk, G. Coban Cifci, and G. Yazici declare that they have no competing interests. Ethical standards: All procedures performed in studies involving human participants or on human tissue were in accordance with the ethical standards of the institutional and/or national research committee and with the 1975 Helsinki declaration and its later amendments or comparable ethical standards. Ethical approval was obtained from the institutional review board (SBA 24/543 & 05.21.24). Informed consent was obtained from all individual participants included in the study.

Figures

Fig. 1
Fig. 1
Kaplan–Meier survival curve for overall survival after progression
See this image and copyright information in PMC

References

    1. Hoffman LM et al (2018) Clinical, radiologic, pathologic, and molecular characteristics of long-term survivors of diffuse intrinsic pontine glioma (DIPG): a collaborative report from the international and european society for pediatric oncology DIPG registries. J Clin Oncol 36(19):1963–1972 - PMC - PubMed
    1. Bailey S et al (2013) Diffuse intrinsic pontine glioma treated with prolonged temozolomide and radiotherapy—results of a united kingdom phase II trial (CNS 2007 04). Eur J Cancer 49(18):3856–3862 - PMC - PubMed
    1. Cacciotti C et al (2021) Reirradiation practices for children with diffuse intrinsic pontine glioma. Neurooncol Pract 8(1):68–74 - PMC - PubMed
    1. Wen PY et al (2010) Updated response assessment criteria for high-grade gliomas: response assessment in neuro-oncology working group. J Clin Oncol 28(11):1963–1972 - PubMed
    1. Kline C et al (2018) Reirradiation and PD‑1 inhibition with nivolumab for the treatment of recurrent diffuse intrinsic pontine glioma: a single-institution experience. J Neurooncol 140(3):629–638 - PubMed

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