Journal of Neuro-Oncology

, Volume 106, Issue 2, pp 391–397 | Cite as

Treatment of recurrent diffuse intrinsic pontine glioma: the MD Anderson Cancer Center experience

  • Johannes E. Wolff
  • Michael E. Rytting
  • Tribhawan S. Vats
  • Peter E. Zage
  • Joann L. Ater
  • Shiao Woo
  • John Kuttesch
  • Leena Ketonen
  • Anita Mahajan
Clinical Study – Patient Study

Abstract

Recurrent diffuse intrinsic pontine gliomas (DIPG) are traditionally treated with palliative care since no effective treatments have been described for these tumors. Recently, clinical studies have been emerging, and individualized treatment is attempted more frequently. However, an informative way to compare the treatment outcomes has not been established, and historical control data are missing for recurrent disease. We conducted a retrospective chart review of patients with recurrent DIPG treated between 1998 and 2010. Response progression-free survival and possible influencing factors were evaluated. Thirty-one patients were identified who were treated in 61 treatment attempts using 26 treatment elements in 31 different regimens. The most frequently used drugs were etoposide (14), bevacizumab (13), irinotecan (13), nimotuzumab (13), and valproic acid (13). Seven patients had repeat radiation therapy to the primary tumor. Response was recorded after 58 treatment attempts and was comprised of 0 treatment attempts with complete responses, 7 with partial responses, 20 with stable diseases, and 31 with progressive diseases The median progression-free survival after treatment start was 0.16 years (2 months) and was found to be correlated to the prior time to progression but not to the number of previous treatment attempts. Repeat radiation resulted in the highest response rates (4/7), and the longest progression-free survival. These data provide a basis to plan future clinical trials for recurrent DIPG. Repeat radiation therapy should be tested in a prospective clinical study.

Keywords

Diffuse intrinsic pontine glioma Chemotherapy Radiation Biomathematics 

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Copyright information

© Springer Science+Business Media, LLC. 2011

Authors and Affiliations

  • Johannes E. Wolff
    • 1
    • 2
    • 3
  • Michael E. Rytting
    • 1
  • Tribhawan S. Vats
    • 1
  • Peter E. Zage
    • 1
    • 4
  • Joann L. Ater
    • 1
  • Shiao Woo
    • 5
  • John Kuttesch
    • 6
  • Leena Ketonen
    • 7
  • Anita Mahajan
    • 8
  1. 1.Department of PediatricsThe University of Texas M. D. Anderson Cancer CenterHoustonUSA
  2. 2.Department of BiostatisticsM. D. Anderson Cancer CenterHoustonUSA
  3. 3.Department of PediatricsTufts Medical CenterBostonUSA
  4. 4.Department of Pediatric OncologyTexas Children’s HospitalHoustonUSA
  5. 5.Department of Radiation OncologyKosair Children’s Hospital/Norton Healthcare University of Louisville School of MedicineLouisvilleUSA
  6. 6.Pediatrics/Hematology/Oncology—H085Penn State Hershey Children’s HospitalHersheyUSA
  7. 7.Department of Diagnostic ImagingM. D. Anderson Cancer CenterHoustonUSA
  8. 8.Department of Radiation OncologyM. D. Anderson Cancer CenterHoustonUSA

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