Background: Brainstem gliomas have a short survival time; chemotherapy has not improved outcome. We report the result obtained with the combination of Radiotherapy and the monoclonal antibody Nimotuzumab in a series of these tumors. Material and methods: 40 children and adolescents treated with irradiation and Nimotuzumab were included between Jan 2009 and December 2015, all with the diagnosis of diffuse infiltrative pontine gliomas (DIPG), irradiated at the Instituto Nacional de Oncologia y Radiobiologia, in Havana, Cuba. Nimotuzumab was applied during the period receiving Radiotherapy and them monthly for one year or more. Results: Median age at diagnosis was 7,9 years (range 3-18 years old); median survival was 18,4 months and Kaplan Meier survival was 42,5% at 2 years and 34,5% at 5 years, established till 9 years. Addition of Nimotuzumab was safe and well tolerated. Conclusion: Combination of Nimotuzumab and Radiotherapy is safe and could increase survival

CitationUp to now chemotherapy has not shown to improve survival in these patients. The outcome of Radiation Therapy (RT) in combination with Nimotuzumab is shown in the present report. Material and Methods: 28 children and adolescents were included between Jan/2009 and Dec/2012 with the diagnosis of BSG and follow-up till January 2015. All patients had Diffuse infiltrative Pontine Gliomas (DIPG) and were irradiated with a dose ranging from 54 to 59.6 Gy at the National Oncology and Radiobiology Institute in Havana, Cuba. Three patients were planned with IMRT and 25 with 3D Conformal RT. Nimotuzumab was indicated at the dose of 150 mg/m 2 weekly during the time of RT treatment, then every 15 days during 8 weeks and finally monthly for 1 year. Univariate and multivariate Cox regression models and Kaplan Meier survival were analyzed to evaluate the survival. Results: Median age at diagnosis was 7 years (range 3-18 years old), median overall survival was 17.3 months (95% CI 14.0-20.5 ) since the beginning of the treatment and the accumulated survival at 5 years of treatment was 42,9%. There was balance in sex, age and dosage of RT in the population. Addition of Nimotuzumab to RT was safe. Conclusions: The combination of Radiotherapy and Nimotuzumab were well tolerated in this brainstem tumours patient's series.

I n Cuba, tumors of the Central Nervous System (CNS) for children and adolescents account between 18 and 20% of all tumors in this group of age. 1-3 The main methods of treatment are surgery, radiotherapy, and chemotherapy. 4 Radiation therapy is a major treatment avenue in medulloblastomas, primitive neuroectodermal tumor (PNET) in some cases of germinomas consist of craneospinal irradiation (CS), and a supplementary boost to the post-operative tumor bed, followed by chemotherapy. In

Background: Brainstem gliomas have a short survival time; chemotherapy has not improved outcome. We report the result obtained with the combination of Radiotherapy and the monoclonal antibody Nimotuzumab in a series of these tumors. Material and methods: 40 children and adolescents treated with irradiation and Nimotuzumab were included between Jan 2009 and December 2015, all with the diagnosis of diffuse infiltrative pontine gliomas (DIPG), irradiated at the Instituto Nacional de Oncologia y Radiobiologia, in Havana, Cuba. Nimotuzumab was applied during the period receiving Radiotherapy and them monthly for one year or more. Results: Median age at diagnosis was 7,9 years (range 3-18 years old); median survival was 18,4 months and Kaplan Meier survival was 42,5% at 2 years and 34,5% at 5 years, established till 9 years. Addition of Nimotuzumab was safe and well tolerated. Conclusion: Combination of Nimotuzumab and Radiotherapy is safe and could increase survival

Diffuse intrinsic brainstem gliomas have a bad prognosis, and short-term survival time. Radiotherapy has been the principal treatment, and chemotherapy has not improved outcome. The anti –EGFR monoclonal antibody Nimotuzumab combined with Radiotherapy was tested in a series of 41 children and adolescents with diffuse intrinsic pontine gliomas (DIPG) included between January 2008 and December 2015 and a follow-up till January 2021.They were irradiated in the Instituto Nacional de Oncologia y Radiobiologia, Havana, Cuba with a median dose of 54 Gy. Nimotuzumab was applied at a dose of 150 mg/m2, weekly during the period of irradiation, then every 2 weeks by 8 doses, and them monthly for 1,2 or more years. A response was observed in 87.8% of patients. Prolonged use of Nimotuzumab was feasible and well tolerated. Median age at diagnosis was 7 years old, median survival was 18.8 months. There were minor toxicities, only Grade I or II. Survival rate at 5 years was 34.1%, stablished till years or more. Two relapsing patients were re-irradiated. The combination of irradiation and Nimotuzumab is an option to increase survival in DIPG.