Abstract
Abstract The therapeutic value of surgery for DIPG has been a subject of controversy. Surgical biopsy provides valuable information on molecular markers of brain gliomas, aiding in further personalized treatment. This retrospective study aimed to elucidate the real-world application of surgery in Diffuse Intrinsic Pontine Glioma (DIPG) in the era of new molecular diagnostics. This study from Guangdong Sanjiu Brain Hospital investigates the surgical landscape in the treatment of Diffuse Intrinsic Pontine Glioma (DIPG) amid the new molecular diagnostics era (Jan 2017 to Feb 2023). Among 184 cases, 58.6% underwent surgery. Notably, 97.2% were introduced to surgery, with 65.8% opting for open surgeries and 34.2% utilizing the Rosa robot. Patients aged 18 and above showed a higher surgery rate (78.3%) than those below 18 (49.1%), revealing a significant difference (P<0.05). The median time from surgery to radiotherapy varied between open (19 days) and stereotactic biopsy (7 days). Complications included increased cranial nerve dysfunction in 20 open biopsy cases. All 108 patients received pathological diagnoses, with 79 having diffuse midline gliomas. Targeted therapy based on second-generation sequencing was administered to seven patients, involving drugs like ribociclib and rigosertib. The study concludes that compared to a decade ago, there is an increased willingness among oncologists to perform brainstem surgery, especially in older patients. Stereotactic biopsy, with fewer side effects, allows swift initiation of radiotherapy. Obtaining lesion tissue during surgery holds promise for new treatments and future research.
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