Article ; Online: Radiation dose response of neurologic symptoms during conformal radiotherapy for diffuse intrinsic pontine glioma.
2020 Volume 147, Issue 1, Page(s) 195–203
Abstract: Purpose: To estimate the rate and magnitude of neurologic symptom change during radiation therapy (RT) and impact of symptom change on survival outcomes in patients with diffuse intrinsic pontine glioma (DIPG).: Methods: From 2006 to 2014, 108 ... ...
Abstract | Purpose: To estimate the rate and magnitude of neurologic symptom change during radiation therapy (RT) and impact of symptom change on survival outcomes in patients with diffuse intrinsic pontine glioma (DIPG). Methods: From 2006 to 2014, 108 patients with newly diagnosed DIPG were treated with conventionally fractionated radiation therapy (RT) to 54 Gy (median) at our institution. The presence and severity of neurologic symptoms related to cranial neuropathy (CN) and cerebellar (CB) and long-tract (LT) signs was reviewed before and weekly during RT for each patient. The rate and magnitude of change for each symptom category was evaluated according to accumulated RT dose. The impact of clinical factors and radiation dose-volume parameters was determined using Cox proportional hazards models. Results: Median dose to first sign of symptomatic improvement was 16.2 Gy (CN), 19.8 Gy (LT) and 21.6 Gy (CB). Most patients showed an improvement by 20 Gy. Larger uninvolved brainstem volume, alone or normalized to total brain (TB) or posterior fossa volume (PF), was associated with shorter time to LT sign improvement (P = 0.044, P = 0.033, and P = 0.05, respectively). Patients with any improvement in CN experienced significantly, yet modestly, prolonged progression-free survival (PFS) and overall survival (OS) (P = 0.002 and P = 0.008, respectively). Tumor volume, with or without normalization to TB or PF, was not significantly associated with PFS or OS. Conclusions: Low cumulative RT doses resulted in neurologic improvement in most patients with DIPG. The volume of brainstem spared by tumor influenced time to symptomatic improvement. Neurologic improvement during RT was associated with superior survival. |
---|---|
MeSH term(s) | Adolescent ; Brain Stem Neoplasms/diagnosis ; Brain Stem Neoplasms/psychology ; Brain Stem Neoplasms/radiotherapy ; Child ; Child, Preschool ; Cohort Studies ; Diffuse Intrinsic Pontine Glioma/diagnosis ; Diffuse Intrinsic Pontine Glioma/psychology ; Diffuse Intrinsic Pontine Glioma/radiotherapy ; Dose Fractionation, Radiation ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Neuropsychology ; Treatment Outcome |
Language | English |
Publishing date | 2020-02-03 |
Publishing country | United States |
Document type | Journal Article |
ZDB-ID | 604875-4 |
ISSN | 1573-7373 ; 0167-594X |
ISSN (online) | 1573-7373 |
ISSN | 0167-594X |
DOI | 10.1007/s11060-020-03415-w |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
Full text online
More links
Kategorien
In stock of ZB MED Cologne/Königswinter
Zs.A 1825: Show issues | Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG) |
Order via subito
This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.