Hypofractionated radiotherapy in the treatment of diffuse intrinsic pontine glioma in children: a single institution's experience
Hypofractionated radiotherapy in the treatment of diffuse intrinsic pontine glioma in children: a single institution's experience
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DOI：
10.1007/s11060-011-0542-4
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发表时间：
2011-09-01
影响因子：
3.9
通讯作者：
Dufour, Christelle
中科院分区：
文献类型：
--
作者：
Negretti, Laura;Bouchireb, Karim;Dufour, Christelle
我们在此报告了我们采用低分割外照射治疗弥漫性桥脑胶质瘤(DIPG)的机构经验。自1996年4月至2004年1月，22例新诊断的DIPG患者(年龄2.9~12.5岁)接受了低分割放射治疗，总剂量为45Gy3Gy3次/天，连续3周。没有同时应用其他治疗方法。在22名患者中，14名患者接受了处方剂量，分15次接受3Gy15次照射，2名患者接受了两种不同射线(光子和中子)的总剂量分别为60Gy和45Gy.5例因不耐受而改为每日2次，1例在2次3和1次2次后死于重度高颅压。在22名儿童中，有14名患者的临床症状有所改善，通常从治疗的第二周开始。未观察到放射治疗的3级或4级急性毒性反应。不需要中断治疗。6例患者在放疗结束后1个月内停用激素。中位进展时间和中位总生存期分别为5.7个月和7.6个月。对于新诊断的DIPG儿童，采用根治性低分割方案的体外放射治疗是可行的，且耐受性良好。然而，在这种情况下，这种养生方法似乎并没有改变总体存活率。它可能代表着一种短期的替代方案，而不是更长时间的方案。
We report herein our institutional experience in the treatment of diffuse intrinsic pontine glioma (DIPG) with a hypofractionated external-beam radiotherapy schedule. Between April 1996 and January 2004, 22 patients (age 2.9-12.5 years) with newly diagnosed DIPG were treated by hypofractionated radiation therapy delivering a total dose of 45 Gy in daily fractions of 3 Gy, given over 3 weeks. No other treatment was applied concomitantly. Fourteen of the 22 patients received the prescribed dose of 45 Gy in 15 fractions of 3 Gy, and 2 patients received a total dose of 60 and 45 Gy with a combination of two different beams (photons and neutrons). In five cases the daily fraction was modified to 2 Gy due to intolerance, and one patient died due to serious intracranial hypertension after two fractions of 3 Gy and one of 2 Gy. Among 22 children, 14 patients showed clinical improvement, usually starting in the second week of treatment. No grade 3 or 4 acute toxicity from radiotherapy was observed. No treatment interruption was needed. In six patients, steroids could be discontinued within 1 month after the end of radiotherapy. Median time to progression and median overall survival were 5.7 months and 7.6 months, respectively. External radiotherapy with a radical hypofractionated regimen is feasible and well tolerated in children with newly diagnosed DIPG. However, this regimen does not seem to change overall survival in this setting. It could represent a short-duration alternative to more protracted regimens.