% IMPORTANT: The following is UTF-8 encoded. This means that in the presence % of non-ASCII characters, it will not work with BibTeX 0.99 or older. % Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or % “biber”. @ARTICLE{Janssens:120496, author = {G. O. Janssens and L. Gandola and S. Bolle and H. Mandeville and M. Ramos-Albiac and K. van Beek and H. Benghiat and B. Hoeben and A. Morales La Madrid and R.-D. Kortmann and D. Hargrave and J. Menten and E. Pecori and V. Biassoni and A. O. von Bueren and D. G. van Vuurden and M. Massimino and D. Sturm$^*$ and M. Peters and C. M. Kramm}, title = {{S}urvival 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.}, journal = {European journal of cancer}, volume = {73}, issn = {0959-8049}, address = {Amsterdam [u.a.]}, publisher = {Elsevier}, reportid = {DKFZ-2017-00925}, pages = {38 - 47}, year = {2017}, abstract = {Overall 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.}, cin = {B062}, ddc = {610}, cid = {I:(DE-He78)B062-20160331}, pnm = {312 - Functional and structural genomics (POF3-312)}, pid = {G:(DE-HGF)POF3-312}, typ = {PUB:(DE-HGF)16}, pubmed = {pmid:28161497}, doi = {10.1016/j.ejca.2016.12.007}, url = {https://inrepo02.dkfz.de/record/120496}, }