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000120496 0247_ $$2doi$$a10.1016/j.ejca.2016.12.007
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000120496 0247_ $$2ISSN$$a0959-8049
000120496 0247_ $$2ISSN$$a1879-0852
000120496 0247_ $$2ISSN$$a1879-2995
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000120496 037__ $$aDKFZ-2017-00925
000120496 041__ $$aeng
000120496 082__ $$a610
000120496 1001_ $$aJanssens, Geert O$$b0
000120496 245__ $$aSurvival benefit for patients with diffuse intrinsic pontine glioma (DIPG) undergoing re-irradiation at first progression: A matched-cohort analysis on behalf of the SIOP-E-HGG/DIPG working group.
000120496 260__ $$aAmsterdam [u.a.]$$bElsevier$$c2017
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000120496 520__ $$aOverall survival (OS) of patients with diffuse intrinsic pontine glioma (DIPG) is poor. The purpose of this study is to analyse benefit and toxicity of re-irradiation at first progression.At first progression, 31 children with DIPG, aged 2-16 years, underwent re-irradiation (dose 19.8-30.0 Gy) alone (n = 16) or combined with systemic therapy (n = 15). At initial presentation, all patients had typical symptoms and characteristic MRI features of DIPG, or biopsy-proven high-grade glioma. An interval of ≥3 months after upfront radiotherapy was required before re-irradiation. Thirty-nine patients fulfilling the same criteria receiving radiotherapy at diagnosis, followed by best supportive care (n = 20) or systemic therapy (n = 19) at progression but no re-irradiation, were eligible for a matched-cohort analysis.Median OS for patients undergoing re-irradiation was 13.7 months. For a similar median progression-free survival after upfront radiotherapy (8.2 versus 7.7 months; P = .58), a significant benefit in median OS (13.7 versus 10.3 months; P = .04) was observed in favour of patients undergoing re-irradiation. Survival benefit of re-irradiation increased with a longer interval between end-of-radiotherapy and first progression (3-6 months: 4.0 versus 2.7; P < .01; 6-12 months: 6.4 versus 3.3; P = .04). Clinical improvement with re-irradiation was observed in 24/31 (77%) patients. No grade 4-5 toxicity was recorded. On multivariable analysis, interval to progression (corrected hazard ratio = .27-.54; P < .01) and re-irradiation (corrected hazard ratio = .18-.22; P < .01) remained prognostic for survival. A risk score (RS), comprising 5 categories, was developed to predict survival from first progression (ROC: .79). Median survival ranges from 1.0 month (RS-1) to 6.7 months (RS-5).The majority of patients with DIPG, responding to upfront radiotherapy, do benefit of re-irradiation with acceptable tolerability.
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000120496 7001_ $$aGandola, Lorenza$$b1
000120496 7001_ $$aBolle, Stephanie$$b2
000120496 7001_ $$aMandeville, Henry$$b3
000120496 7001_ $$aRamos-Albiac, Monica$$b4
000120496 7001_ $$avan Beek, Karen$$b5
000120496 7001_ $$aBenghiat, Helen$$b6
000120496 7001_ $$aHoeben, Bianca$$b7
000120496 7001_ $$aMorales La Madrid, Andres$$b8
000120496 7001_ $$aKortmann, Rolf-Dieter$$b9
000120496 7001_ $$aHargrave, Darren$$b10
000120496 7001_ $$aMenten, Johan$$b11
000120496 7001_ $$aPecori, Emilia$$b12
000120496 7001_ $$aBiassoni, Veronica$$b13
000120496 7001_ $$avon Bueren, Andre O$$b14
000120496 7001_ $$avan Vuurden, Dannis G$$b15
000120496 7001_ $$aMassimino, Maura$$b16
000120496 7001_ $$0P:(DE-He78)a46a5b2a871859c8e2d63d2f8c666807$$aSturm, Dominik$$b17$$udkfz
000120496 7001_ $$aPeters, Max$$b18
000120496 7001_ $$aKramm, Christof M$$b19
000120496 773__ $$0PERI:(DE-600)1468190-0$$a10.1016/j.ejca.2016.12.007$$gVol. 73, p. 38 - 47$$p38 - 47$$tEuropean journal of cancer$$v73$$x0959-8049$$y2017
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