HG-06RE-IRRADIATION (RE-RT) FOR CHILDREN WITH RELAPSING DIFFUSE INTRINSIC PONTINE GLIOMA (DIPG): BETTER SURVIVAL AND BETTER TIME

Abstract

HG-06. RE-IRRADIATION (RE-RT) FOR CHILDREN WITH RELAPSING DIFFUSE INTRINSIC PONTINE GLIOMA (DIPG): BETTER SURVIVAL AND BETTER TIME Maura Massimino1, Emilia Pecori1, Elisabetta Schiavello1, Veronica Biassoni1, Emanuele Pignoli1, Barbara Diletto1, Filippo Spreafico1, Michela Casanova1, Roberto Luksch1, Andrea Ferrari1, Monica Terenziani1, Marta Podda1, Cristina Meazza1, Serena Catania1, Stefano Chiaravalli1, Nadia Puma1, Stefano Bergamaschi1, Loris De Cecco1, Andrea Anichini1, Manila Antonelli3, Piergiorgio Modena2, Francesca Buttarelli3, Felice Giangaspero3, and Lorenza Gandola1; Fond. IRCCS Istituto Nazionale dei Tumori, Milano, Italy; Ospedale S.Anna, Como, Italy; Universita Sapienza, Roma, Italy Since 2009 we launched a strategy for children with centrally reviewed MRI DIPG diagnosis. Vinorelbine with nimotuzumab–an anti-EGFR monoclonal antibody-were weekly administered during the delivery of 54 Gy irradiation, 1.8 Gy/fraction daily, and for a total of 12 weeks, thereafter any other week until tumor progression or for two years duration. Since 7/2011 re-RT was offered both in case of local/disseminated progression: for local it consisted of 19.8 G/11 daysfractions; if needed, craniospinal irradiation (CSI) dose was 36 Gy/20 fractions. Of 40 patients treated, 29 had local (24) or disseminated (5) progression and 19 were given local (16) or CS (3) re-irradiation a median 8 months after first radiotherapy (2.5-19 months). Reasons for not re-irradiating the other 10 children were: progression before 7/2011(4), refusal(4), too poor PS(2); progression site were not different in the two groups. Survival after re-irradiation lasted between two weeks-14 months, median 6; a statistically different median OS between the reirradiated/not-reirradiated children was found, being 16 and 12 months, respectively(P 1⁄4 0.003). Re-irradiation induced, in 17 radiologically evaluated patients: 9 tumor volume reduction, 3 stable volumes, while 5 had progression; 14 had symptom amelioration and 13 steroid suspension. 8/9 volume reductions were obtained after same response at previous irradiation while one had stable disease after first irradiation. No adverse event occurred. Re-irradiation after progression was a concrete benefit for both OS and quality of patients life with symptom amelioration in 14/19. This option is worth to be offered also in case of disseminated progression. Neuro-Oncology 18:iii48–iii77, 2016. doi:10.1093/neuonc/now073.5 #The Author(s) 2016. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.