Adjuvant Therapy for Diffuse Intrinsic Pontine Gliomas in Children

Radiation Therapy

• Radiation therapy standard in children: Involved field external beam radiation therapy is the standard therapy for diffuse intrinsic pontine gliomas. Standard dose in the U.S. is delivered in 30–33 daily fractions of 1.8 Gy/fraction. 
• Reliable but temporary benefit: Significant clinical improvement occurs in 85% of patients receiving radiation therapy. However, the improvement is usually transient, lasting only 3– 4 months, after which a progressive decline in clinical status returns (94).

Chemotherapy

• Not of proven efficacy: To date, no chemotherapeutic agent, either alone or in combination, or in conjunction with radiation therapy, has altered the natural history of diffuse intrinsic pontine gliomas.  Many patients are enrolled in clinical trials of new agents or previously used agents in previously untested combinations.