Review of dose fractionation schemes for pontine glioma irradiation

Ferrat Dincoglan, Murat Beyzadeoglu, Omer Sager*, Selcuk Demiral, Bora Uysal, Hakan Gamsiz, Fatih Ozcan, Onurhan Colak and Bahar Dirican

Brainstem tumors constitute approximately 10% to 15% of CNS neoplasms in the pediatric population, and most common of brainstem tumors is diffuse intrinsic pontine glioma (DIPG). Children with DIPG are typically diagnosed at the 5th to 10th years of their lives, with tumors being more frequently located in the pons rather than the midbrain or medulla oblongata. Symptomatology of patients may be severe and associated with compression of nuclei and tracts in the pons leading to cranial nerve dysfunctions. The wide spectrum of symptomatology may result in profound deterioration of the patients’ quality of life, and management is required for symptomatic relief. Complete removal of DIPG is typically not achievable given the diffuse and infiltrating nature of the disease with significant risk of excessive toxicity associated with surgical interventions. Nevertheless, surgical biopsy may be considered as a technically feasible procedure for selected patients to allow for histopathological verification and acquisition of biological data to aid in decision making for management. Utility of chemotherapy, biological and targeted therapies is being actively investigated as a promising treatment strategy, however, there is still room for improvement for routine clinical use. Radiation therapy (RT) remains to be a principal management approach for DIPG. Herein, we provide a concise review of dose fractionation schemes for pontine glioma irradiation.

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Published on: Jun 15, 2020 Pages: 73-78

Full Text PDF Full Text HTML DOI: 10.17352/2455-2968.000101
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