Mount Sinai Explores Multi-Course Radiation Therapy for Pediatric Brain Tumor
Research undertaken by the Icahn School of Medicine at Mount Sinai has presented the largest data set to date concerning the administration of three courses of radiation therapy for children with diffuse intrinsic pontine glioma (DIPG), a particularly aggressive brain tumor. The study, detailed in Practical Radiation Oncology, aggregates both Mount Sinai's and globally available cases, providing valuable insights into recurrent DIPG treatment.
DIPG, which primarily affects children between the ages of 5 and 10, resides in the brainstem, thus making surgical removal unfeasible. The prognosis for DIPG is dire, with average survival after diagnosis ranging from 12 to 14 months. Radiation therapy is the conventional treatment, known to decelerate tumor progression and improve symptoms temporarily. The frequent recurrence of the tumor poses a continued challenge, and the potential benefits of a third radiation course had been largely underexplored due to concerns over possible damage to healthy brain tissue from repeated radiation exposure.
The study from Mount Sinai assessed all known global cases, enhancing them with data from two local patients, culminating in a total of 12 evaluated instances. The analysis demonstrated a median survival of 27 months post-diagnosis and highlighted symptomatic improvements and enhanced quality of life following the third course of radiation therapy.
Dr. Stanislav Lazarev, Associate Professor of Radiation Oncology at Mount Sinai, remarked on the potential merits of an additional radiation course in carefully chosen patients, emphasizing the symptom relief and extended time without unacceptable side effects that this treatment could offer. Dr. Lauren Jacobs, a co-author of the study, reinforced this exploratory finding, suggesting that while not curative, additional radiation therapy could facilitate better conditions for a subset of patients.
Given the study's retrospective nature and limited patient number, further research is necessary to identify which patients would benefit most and to refine optimal treatment schedules. The Mount Sinai research team aims to pursue a prospective clinical trial to investigate further the efficacy and safety of multi-course radiation therapy for recurrent DIPG. This approach utilizes standard radiation therapy methods accessible globally, proposing that widespread application could follow if positive results are confirmed by future studies.