Details

Autor(en) / Beteiligte

• Krishnatry, Rahul
• Manjali, Jifmi Jose
• Chinnaswamy, Girish
• Chatterjee, Abhishek
• Goda, Jayant Sastri
• Janu, Amit
• Sahu, Arpita
• Jalali, Rakesh
• Gupta, Tejpal

Titel

Clinical approach to re-irradiation for recurrent diffuse intrinsic pontine glioma

Ist Teil von

• Japanese journal of clinical oncology, 2021-05, Vol.51 (5), p.762-768

Ort / Verlag

England: Oxford University Press

Erscheinungsjahr

2021

Link zum Volltext

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• Abstract Background We present our institutional approach for re-irradiation in diffuse intrinsic pontine glioma and their outcomes. Methods Consecutive patients of recurrent diffuse intrinsic pontine glioma treated with re-irradiation (January 2015–September 2019) were reviewed retrospectively to describe the clinical-response-based approach followed for the dose and volume decision. Outcomes were defined with clinical and steroid response criteria and survival endpoints included progression-free survival and overall survival as cumulative(c) overall survival and re-irradiation overall survival (re-irradiation starting to death). The Kaplan–Meier method and log-rank test were used for survival analysis. Results Twenty-patient cohort with a median (m) age of 7.5 years, m-progression-free survival of 8.4 months and m-Lansky performance score of 50 received re-irradiation of which 17 (85%) were called clinical responders. The median re-irradiation-overall survival with 39.6–41.4, 43.2 and 45 Gy were 5.8, 7 and 5.3 months, respectively. One-month post-re-irradiation steroid independent status was a significant predictor of better survival outcomes (overall survival, P≤0.004). No ≥ grade 3 toxicities were noticed. Two patients succumbed to intra-tumoral hemorrhage. Conclusions Higher doses of re-irradiation based on a clinical-response-based approach show improvement in survival and steroid dependence rates with acceptable toxicity. Steroid independent status at 1-month post-re-irradiation predicts better outcomes. Prospective studies may validate this with quality of life data. Re-irradiation significantly improves survival and steroid dependence and re-irradiation dose of 39–45 Gy can be safely used. Steroid independent status at 1-month post-re-irradiation is a predictor of better outcomes.