Observational studyChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2026
Reirradiation for diffuse intrinsic pontine glioma in an upper middle-income country: does full dose improve outcomes?
Observational study in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeReirradiation (reRT) during diffuse intrinsic pontine glioma (DIPG) progression has emerged as a potential treatment strategy for prolonging survival.
methodsThis retrospective, single-center observational study was conducted on children diagnosed with DIPG between 2010 and 2025, and data from 58 were collected. Doses for reRT were as follows: 50-54 Gy (1.8-2.0 Gy daily/fractions) or 39 Gy (3 Gy daily/fractions). Overall survival (OS) was defined as the time from diagnosis to the date of death and reRT OS, reirradiation starting to death. The Kaplan-Meier method and log-rank test were used for survival analysis.
resultsThe median age was 7.1 years (range 2.9-16.2 years). Twenty-six patients underwent a biopsy. The H3K27M mutation was the most prevalent in our study, followed by TP53 altered gene. Twenty-two patients underwent reRT at progression. The median time from initial treatment to reRT was 9.9 months (range 6.7 to 20.5 months). Seven of the 22 patients received reRT at a dose of 39 Gy while 14 at doses of 50-54 Gy. The median OS from reRT to death was 5.8 months (range, 0.9-18.3 months). Patients who received reRT had a longer OS compared to those who did not (median OS of 17.9 versus 9.8 months; p = 0.005). Longer time for progression (> 9 months) and dose of reRT > 50 Gy were statistically significantly correlated with better OS. Reirradiation was generally well-tolerated by all patients.
conclusionsThis study offers molecular insights into this tumor type and presents a therapeutic option with higher nominal doses reRT within a palliative context to prolong survival of these patients.
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