The Role of Reirradiation in Childhood Progressive Diffuse Intrinsic Pontine Glioma (DIPG): An Ongoing Challenge beyond Radiobiology
To investigate the clinical impact of multiple courses of irradiation on pediatric patients with progressive diffuse intrinsic pontine glioma (DIPG), we conducted a retrospective case series on three children treated at our institution from 2018 to 2022. All children were candidates to receive syste...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-10-01
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| Series: | Brain Sciences |
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| Online Access: | https://www.mdpi.com/2076-3425/13/10/1449 |
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| author | Maria Chiara Lo Greco Roberto Milazzotto Rocco Luca Emanuele Liardo Pietro Valerio Foti Stefano Palmucci Antonio Basile Stefano Pergolizzi Corrado Spatola |
| author_facet | Maria Chiara Lo Greco Roberto Milazzotto Rocco Luca Emanuele Liardo Pietro Valerio Foti Stefano Palmucci Antonio Basile Stefano Pergolizzi Corrado Spatola |
| author_sort | Maria Chiara Lo Greco |
| collection | DOAJ |
| description | To investigate the clinical impact of multiple courses of irradiation on pediatric patients with progressive diffuse intrinsic pontine glioma (DIPG), we conducted a retrospective case series on three children treated at our institution from 2018 to 2022. All children were candidates to receive systemic therapy with vinorelbine and nimotuzumab. Radiotherapy was administered to a total dose of 54 Gy. At any disease progression, our local tumor board evaluated the possibility of offering a new course of radiotherapy. To determine feasibility and assess toxicity rates, all children underwent clinical and hematological evaluation both during and after the treatment. To assess efficacy, all children performed contrast-enhanced MRI almost quarterly after the end of the treatment. In all children, following any treatment course, neurological improvement (>80%) was associated with a radiological response (41.7–46%). The longest overall survival (24 months) was observed in the child who underwent three courses of radiotherapy, without experiencing significant side effects. Even though it goes beyond the understanding of conventional radiobiology, first and second reirradiation in pediatric patients with progressive DIPG may represent a feasible and safe approach, capable of increasing overall survival and disease-free survival in selected patients and improving their quality of life. |
| first_indexed | 2024-03-10T21:23:21Z |
| format | Article |
| id | doaj.art-3e1a942a1ad248e7bb7649dc4125739e |
| institution | Directory Open Access Journal |
| issn | 2076-3425 |
| language | English |
| last_indexed | 2024-03-10T21:23:21Z |
| publishDate | 2023-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Brain Sciences |
| spelling | doaj.art-3e1a942a1ad248e7bb7649dc4125739e2023-11-19T15:53:06ZengMDPI AGBrain Sciences2076-34252023-10-011310144910.3390/brainsci13101449The Role of Reirradiation in Childhood Progressive Diffuse Intrinsic Pontine Glioma (DIPG): An Ongoing Challenge beyond RadiobiologyMaria Chiara Lo Greco0Roberto Milazzotto1Rocco Luca Emanuele Liardo2Pietro Valerio Foti3Stefano Palmucci4Antonio Basile5Stefano Pergolizzi6Corrado Spatola7Radiation Oncology Unit, Department of Biomedical, Dental and Morphological and Functional Imaging Sciences, University of Messina, 98122 Messina, ItalyRadiation Oncology Unit, Department of Medical, Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95123 Catania, ItalyRadiation Oncology Unit, Department of Medical, Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95123 Catania, ItalyRadiology I Unit, Department of Medical Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95123 Catania, ItalyRadiology I Unit, Department of Medical Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95123 Catania, ItalyRadiology I Unit, Department of Medical Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95123 Catania, ItalyRadiation Oncology Unit, Department of Biomedical, Dental and Morphological and Functional Imaging Sciences, University of Messina, 98122 Messina, ItalyRadiation Oncology Unit, Department of Medical, Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95123 Catania, ItalyTo investigate the clinical impact of multiple courses of irradiation on pediatric patients with progressive diffuse intrinsic pontine glioma (DIPG), we conducted a retrospective case series on three children treated at our institution from 2018 to 2022. All children were candidates to receive systemic therapy with vinorelbine and nimotuzumab. Radiotherapy was administered to a total dose of 54 Gy. At any disease progression, our local tumor board evaluated the possibility of offering a new course of radiotherapy. To determine feasibility and assess toxicity rates, all children underwent clinical and hematological evaluation both during and after the treatment. To assess efficacy, all children performed contrast-enhanced MRI almost quarterly after the end of the treatment. In all children, following any treatment course, neurological improvement (>80%) was associated with a radiological response (41.7–46%). The longest overall survival (24 months) was observed in the child who underwent three courses of radiotherapy, without experiencing significant side effects. Even though it goes beyond the understanding of conventional radiobiology, first and second reirradiation in pediatric patients with progressive DIPG may represent a feasible and safe approach, capable of increasing overall survival and disease-free survival in selected patients and improving their quality of life.https://www.mdpi.com/2076-3425/13/10/1449DIPGhigh-grade gliomamidline gliomaspediatricsreirradiationvinorelbine |
| spellingShingle | Maria Chiara Lo Greco Roberto Milazzotto Rocco Luca Emanuele Liardo Pietro Valerio Foti Stefano Palmucci Antonio Basile Stefano Pergolizzi Corrado Spatola The Role of Reirradiation in Childhood Progressive Diffuse Intrinsic Pontine Glioma (DIPG): An Ongoing Challenge beyond Radiobiology Brain Sciences DIPG high-grade glioma midline gliomas pediatrics reirradiation vinorelbine |
| title | The Role of Reirradiation in Childhood Progressive Diffuse Intrinsic Pontine Glioma (DIPG): An Ongoing Challenge beyond Radiobiology |
| title_full | The Role of Reirradiation in Childhood Progressive Diffuse Intrinsic Pontine Glioma (DIPG): An Ongoing Challenge beyond Radiobiology |
| title_fullStr | The Role of Reirradiation in Childhood Progressive Diffuse Intrinsic Pontine Glioma (DIPG): An Ongoing Challenge beyond Radiobiology |
| title_full_unstemmed | The Role of Reirradiation in Childhood Progressive Diffuse Intrinsic Pontine Glioma (DIPG): An Ongoing Challenge beyond Radiobiology |
| title_short | The Role of Reirradiation in Childhood Progressive Diffuse Intrinsic Pontine Glioma (DIPG): An Ongoing Challenge beyond Radiobiology |
| title_sort | role of reirradiation in childhood progressive diffuse intrinsic pontine glioma dipg an ongoing challenge beyond radiobiology |
| topic | DIPG high-grade glioma midline gliomas pediatrics reirradiation vinorelbine |
| url | https://www.mdpi.com/2076-3425/13/10/1449 |
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