Prospective neuraxis MRI surveillance reveals a high risk of leptomeningeal dissemination in diffuse intrinsic pontine glioma.

Journal of Neuro-oncology
Rajni SethiAshwatha Narayana

Abstract

Prognosis of diffuse intrinsic pontine gliomas (DIPGs) remains poor. Failure has been predominantly local, with leptomeningeal dissemination (LD) occurring in 4-33% of patients in pre-MRI era series. Routine craniospinal imaging after initial treatment may reveal other relapse patterns relapse. Sixteen consecutive pediatric patients with DIPG treated between 2006 and 2009 were retrospectively reviewed. Treatment regimens, recurrence patterns, survival, and pathologic diagnosis were recorded. Fourteen patients received involved-field radiotherapy to 54 Gy, and two patients received craniospinal irradiation for LD at presentation. Neuraxis MRI was performed at diagnosis and at 4 month intervals following radiotherapy. Fifteen patients have had progression of disease (median progression-free survival 5.0 ± 1.2 months), and 13 patients have died (median survival 9.0 ± 1.4 months). Local failure occurred in 12 patients (75%). LD occurred in nine patients (56%). LD was present at diagnosis in three patients, after initial staging and treatment in six patients, and during autopsy in two patients. Median overall survival was 12.0 ± 3.3 months without LD and 8.0 ± 2.1 months with LD (P = 0.059, log rank test). Median progression-free su...Continue Reading

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Citations

May 3, 2011·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Soumen KhatuaJohn R W Kestle
Dec 25, 2019·The Cochrane Database of Systematic Reviews·Gerard ThompsonMichael D Jenkinson
Dec 13, 2012·Journal of Neuro-oncology·Zhiping ZhouMark M Souweidane
Nov 12, 2015·Frontiers in Oncology·Magimairajan Issai Vanan, David D Eisenstat
Feb 27, 2017·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Zhiping ZhouJeffrey P Greenfield
Jan 11, 2012·Journal of Neuro-oncology·Yasuyuki AokiNalin Gupta
Sep 17, 2015·Journal of Child Neurology·Tammy Hennika, Oren J Becher
Sep 30, 2020·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Ralph E NavarroEveline Teresa Hidalgo
Nov 5, 2014·CNS Oncology·Soumen Khatua, Wafik Zaky
Feb 2, 2019·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Chloé Louise GelderEric Bouffet
Jan 6, 2021·Journal of Neuro-oncology·Brandon WummerCatherine Flores

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