Reirradiation in patients with diffuse intrinsic pontine gliomas: The Canadian experience

Lassaletta, Álvaro; Strother, Douglas; Laperrière, Normand; Hukin, Juliette; Vanan, Magimairajan Issai; Goddard, Karen; Lafay‐Cousin, Lucie; Johnston, Donna L.; Zelcer, Shayna; Zápotocký, Michal; Rajagopal, Revathi; Ramaswamy, Vijay; Hawkins, Cynthia; Tabori, Uri; Huang, Annie; Bartels, Ute; Bouffet, Éric

doi:10.1002/pbc.26988

Cited by 64 publications

(55 citation statements)

References 17 publications

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“…Reirradiation has an emerging role as a palliative treatment for children with recurrent brainstem glioma . However, the role of repeat RT has been poorly studied in non‐pontine HGG.…”

Section: Introductioncontrasting

confidence: 99%

“…Patients with rapidly progressive HGG after initial RT may be less likely to be offered reirradiation. Nonetheless, this finding of an OS benefit to RT2 is consistent with studies of reirradiation for brainstem glioma …”

Section: Discussionmentioning

confidence: 96%

“…There is an increasing role for repeat irradiation in patients with recurrent brainstem glioma (diffuse intrinsic pontine glioma, or DIPG) . Use of RT2 in this group of patients is associated with palliative improvement in symptoms and longer survival when compared with patients not selected for RT2 . Repeat RT in DIPG is the subject of several ongoing or completed prospective studies around the world (ClinicalTrials.gov identifiers: NCT01777633 and NCT03126266).…”

Section: Discussionmentioning

confidence: 99%

“…Nonetheless, this finding of an OS benefit to RT2 is consistent with studies of reirradiation for brainstem glioma. 7 In this study, RT2 was permitted to overlap with previously irradiated OARs. Cumulative OAR doses exceeded traditional tolerances for single courses of RT.…”

Section: Discussionmentioning

confidence: 99%

“…5 Reirradiation has an emerging role as a palliative treatment for children with recurrent brainstem glioma. 7 However, the role of repeat RT has been poorly studied in non-pontine HGG. Therefore, the goals of this study were to report the clinical outcomes, disease control, and toxicities associated with reirradiation of children with recurrent supratentorial HGG.…”

Section: Introductionmentioning

confidence: 99%

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Repeat irradiation for children with supratentorial high‐grade glioma

Tsang

Oliveira

Bouffet

et al. 2019

Pediatric Blood & Cancer

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Background There are very few studies about the role of repeat irradiation (RT2) for children with recurrent supratentorial high‐grade glioma (HGG). It was the aim of this study to assess the effectiveness and safety of RT2 in this population. Procedure This was a retrospective cohort study of 40 children age 18 years and under with recurrent supratentorial HGG who had received at least one course of RT. In‐field reirradiation volumes included focal or whole brain RT, with doses ranging from 30 to 54 Gy. The primary endpoint was overall survival (OS) from the first day of RT2. Results Fourteen patients underwent RT2. The median survival of these patients was 6.5 months. Patients with ≥12 months elapsed time between RT1 and RT2 experienced longer OS than patients who had < 12 months (P = 0.009). There was no difference in OS between patients with or without germline mutations (e.g., Lynch, Li–Fraumeni, or constitutional mismatch‐repair deficiency, P = 0.20). Ten patients received RT2 that overlapped with RT1 volumes for locally recurrent disease. Of this group, 80% experienced clinical benefit from in‐field RT2, defined as clinical/radiologic response or stable disease. Ninety‐three percent completed the prescribed course of RT2, with one patient developing grade 3 radiation necrosis four months after RT2. When compared with 26 patients who were not offered reirradiation, those selected for RT2 had improved median survival from the time of first disease progression (9.4 vs 3.8 months, P = 0.005). Conclusions Reirradiation for children with recurrent supratentorial HGG is a safe, effective treatment that provides short‐term disease control.

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“…Reirradiation has an emerging role as a palliative treatment for children with recurrent brainstem glioma . However, the role of repeat RT has been poorly studied in non‐pontine HGG.…”

Section: Introductioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Repeat irradiation for children with supratentorial high‐grade glioma

Tsang

Oliveira

Bouffet

et al. 2019

Pediatric Blood & Cancer

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Radiosurgery, reirradiation, and brachytherapy

Prasad

Vern-Gross

Wolden

2021

Pediatric Blood & Cancer

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Radiosurgery and brachytherapy are potentially useful treatment techniques that are sparingly applied in pediatric oncology. They are often used in the setting of reirradiation for recurrent or metastatic tumors. Reirradiation in children with recurrent tumors is complicated by the tolerance of critical organs and the potential risks for overall long‐term dose‐dependent complications. We review the current literature available in support of reirradiation and the use of radiosurgery and brachytherapy in pediatric patients.

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