Rthp-04. Reirradiation for Diffuse Intrinsic Pontine Glioma: a Single-institution Experience
Year: 2016
Type: conference-abstract
Abstract: Recurrent diffuse intrinsic pontine glioma (DIPG) is a therapeutic challenge for providers as most patients die within one year after progression. We describe our experience using reirradiation in six recurrent DIPG patients, both with and without concurrent programmed cell death protein 1 (PD-1) inhibition. We completed a retrospective chart review of six pediatric DIPG patients who underwent reirradiation at time of disease recurrence, and report details of their radiation therapy, use of concomitant PD-1 inhibition with nivolumab, and their respective outcomes. A total of six patients (two males, four females) with an average age of nine years at initial diagnosis were included. Median time to reirradiation was eight, and 12 months in patients without, and with PD-1 inhibition, respectively. Three patients received PD-1 inhibition concurrently with radiation. Four patients received 24 Gray (Gy) in 12 fractions, one received 24 Gy in 10 fractions, and one received 30.6 Gy in 17 fractions. Five patients progressed after reirradiation and died of their disease; one remains alive. All patients tolerated reirradiation with no significant side effects, and five of the six patients experienced clinical and radiographic improvement. Median overall survival (OS) from time of reirradiation was five months, and eight months in patients without, and with PD-1 inhibition, respectively. One patient receiving reirradiation with concomitant PD-1 inhibition remains alive without evidence of progression and with significant clinical improvement including near return of independent ambulation and ability to swallow. Our experience demonstrates the feasibility of reirradiation for recurrent DIPG and illustrates its potential efficacy in symptom management and prolongation of life, which may be furthered with the addition of concomitant PD-1 inhibition.
Source: Neuro-Oncology
Language: English
Subfield: Genetics (clinical)
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2588814101