International Journal of Radiation Oncology * Biology * Physics
Volume 73, Issue 3 , Pages 722-726 , 1 March 2009

The Role of Hypofractionation Radiotherapy for Diffuse Intrinsic Brainstem Glioma in Children: A Pilot Study

  • Geert O.R.J. Janssens, M.D.

      Affiliations

    • Department of Radiation Oncology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
    • Corresponding Author InformationReprint requests to: G. O. R. J. Janssens, MD, Radboud University Nijmegen Medical Centre, Department of Radiation Oncology, Postbox 9101, 6500 HB Nijmegen, The Netherlands. Phone: +31-24-3614515; Fax: +31-24-3610792
    • ,
  • Corrie E.M. Gidding, Ph.D.

      Affiliations

    • Department of Pediatric Oncology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
    • ,
  • Erik J. Van Lindert, Ph.D.

      Affiliations

    • Department of Neurosurgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
    • ,
  • Foppe R. Oldenburger, M.D.

      Affiliations

    • Department of Radiation Oncology, Academic Medical Center Amsterdam, Amsterdam, The Netherlands
    • ,
  • Corrie E. Erasmus, M.D.

      Affiliations

    • Department of Pediatric Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
    • ,
  • Antoinette Y.N. Schouten-Meeteren, Ph.D.

      Affiliations

    • Department of Pediatric Oncology, Academic Medical Center Amsterdam, Amsterdam, The Netherlands
    • ,
  • Johannes H.A.M. Kaanders, Ph.D.

      Affiliations

    • Department of Radiation Oncology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

Received 7 March 2008 ,Revised 4 May 2008 ,Accepted 6 May 2008.

References 

  1. Smith MA, Freidlin B, Ries LA, et al. Trends in reported incidence of primary malignant brain tumors in children in the United States. J Natl Cancer Inst. 1998;90:1269–1277
  2. Hargrave D, Bartels U, Bouffet E. Diffuse brainstem glioma in children: Critical review of clinical trials. Lancet Oncol. 2006;7:241–248
  3. Donaldson SS, Laningham F, Fisher PG. Advances toward an understanding of brainstem gliomas. J Clin Oncol. 2006;24:1266–1272
  4. Mandell LR, Kadota R, Freeman C, et al. There is no role for hyperfractionated radiotherapy in the management of children with newly diagnosed diffuse intrinsic brainstem tumors: Results of a Pediatric Oncology Group phase III trial comparing conventional versus hyperfractionated radiotherapy. Int J Radiat Oncol Biol Phys. 1999;43:959–964
  5. Korones DN. Treatment of newly diagnosed diffuse brain stem gliomas in children: In search of the holy grail. Expert Rev Anticancer Ther. 2007;7:663–674
  6. Slotman BJ, Kralendonk JH, van Alphen HA, et al. Hypofractionated radiation therapy in patients with glioblastoma multiforme: Results of treatment and impact of prognostic factors. Int J Radiat Oncol Biol Phys. 1996;34:895–898
  7. Hulshof MC, Schimmel EC, Andries Bosch G, et al. Hypofractionation in glioblastoma multiforme. Radiother Oncol. 2000;54:143–148
  8. Zimmerman RA. Neuroimaging of primary brainstem gliomas: Diagnosis and course. Pediatric Neurosurg. 1996;25:45–53
  9. Langmoen IA, Lundar T, Storm-Mathisen I, et al. Management of pediatric pontine gliomas. Childs Nerv Syst. 1991;7:13–15
  10. Freeman CR, Bourquin PM, Sanford RA, et al. Long term survivors of childhood brain stem gliomas with hyperfractionated radiotherapy. Clinical characteristics and treatment related toxicities. The Pediatric Oncology Group. Cancer. 1996;77:555–562
  11. Freeman CR, Kepner J, Kun LE, et al. A detrimental effect of a combined chemotherapy-radiotherapy approach in children with diffuse intrinsic brain stem gliomas?. Int J Radiat Oncol Biol Phys. 2000;47:561–564
  12. Packer RJ, Boyett JM, Zimmerman RA, et al. Outcome of children with brain stem gliomas after treatment with 7800cGy of hyperfractionated radiotherapy. A Children's Cancer Group Phase I/II trial. Cancer. 1994;74:1827–1834
  13. Bouffet E, Raquin M, Doz F, et al. Radiotherapy followed by high-dose busulfan and thiotepa: A prospective assessment of high-dose chemotherapy in children with diffuse pontine gliomas. Cancer. 2000;88:685–692
  14. Kretschmar CS, Tarbell NJ, Barnes PD, et al. Pre-irradiation chemotherapy and hyperfractionated radiation therapy 66Gy for children with brain stem tumors: A phase II study of the Pediatric Oncology Group, Protocol 8833. Cancer. 1993;72:1404–1413
  15. Lewis J, Lucraft H, Gholkar A. UKCCSG study of accelerated radiotherapy for pediatric brain stem gliomas. United Kingdom Childhood Cancer Study Group. Int J Radiat Biol Phys. 1997;38:925–929
  16. Zagzag D, Miller DC, Knopp E, et al. Primitive neuro-ectodermal tumors of the brainstem: Investigation of seven cases. Pediatrics. 2000;106:1045–1053
  17. Burger PC, Yu IT, Tihan T, et al. Atypical teratoid/rhabdoid tumor of the central nervous system: A highly malignant tumor of infancy and childhood frequently mistaken for medulloblastoma. A Pediatric Oncology Group Study. Am J Surg Pathol. 1998;22:1083–1092
  18. Freeman CR, Krischer JP, Sanford RA, et al. Final results of a study of escalating doses of hyperfractionated radiotherapy in brain stem tumors in children: A Pediatric Oncology Group Study. Int J Radiat Biol Phys. 1993;27:197–206
  19. Haas-Kogan DA, Kogan SS, Yount G, et al. p53 function influences the effect of fractionated radiotherapy on glioblastoma tumors. Int J Radiat Oncol Biol Phys. 1999;43:399–403
  20. Bernier-Chastagnier V, Grill J, Doz F, et al. Topotecan as a radiosensitizer in the treatment of children with malignant diffuse brainstem gliomas: Results of a French Society of Paediatric Oncology Phase II Study. Cancer. 2005;104:2792–2797

 Presented at the 13th International Symposium on Pediatric Neuro-Oncology (ISPNO), Chicago, IL, June 29–July 2, 2008.

 Conflict of interest: none.

PII: S0360-3016(08)00932-2

doi: 10.1016/j.ijrobp.2008.05.030

International Journal of Radiation Oncology * Biology * Physics
Volume 73, Issue 3 , Pages 722-726 , 1 March 2009

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