{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T01:24:46Z","timestamp":1792113886513,"version":"4.4.0"},"reference-count":26,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T00:00:00Z","timestamp":1738627200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Diffuse intrinsic pontine glioma (DIPG) is a challenging pediatric tumor that frequently progresses within the first year following local radiotherapy. However, several small studies have suggested that re\u2010irradiation may improve quality of life and extend overall survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p>This retrospective study included 109 children who experienced disease progression \u22653\u00a0months after their initial radiotherapy, and subsequently received re\u2010irradiation at a single institution. These patients were compared with a cohort of 60 children, meeting the same criteria, who were treated before adopting the re\u2010irradiation policy and received only the best supportive care (BSC). Most of the re\u2010irradiated children (94%) received first radiation dose as hypofractionation (39\u00a0Gy\/13 fractions).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The re\u2010irradiation group demonstrated significantly higher overall survival (OS) rates after the first progression, with a 6\u2010month OS of 42% (95% CI: 34%\u201353%) compared to 16% (95% CI: 8.9%\u201332%) in the BSC group (<jats:italic>p<\/jats:italic> &lt; 0.001). Re\u2010irradiation reduced the hazard of death by more than half (HR = 0.45, <jats:italic>p<\/jats:italic> &lt; 0.001). Clinical response (<jats:italic>p<\/jats:italic> &lt; 0.001) and radiological response (<jats:italic>p<\/jats:italic> = 0.016) were significant predictors of improved survival. While the time from initial radiotherapy to progression (<jats:italic>p<\/jats:italic> = 0.059) and higher re\u2010irradiation doses (<jats:italic>p<\/jats:italic> = 0.074) were associated with improved OS, these factors did not reach statistical significance but may represent potential prognostic indicators.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Re\u2010irradiation improved the OS in children with progression of DIPG and alleviated their signs and symptoms.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.31587","type":"journal-article","created":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T04:53:06Z","timestamp":1738731186000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Re\u2010Irradiation for the Progressive Pediatric Diffuse Intrinsic Pontine Glioma: A Report on 109 Children From a Single Center"],"prefix":"10.1002","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1999-6528","authenticated-orcid":false,"given":"Mohamed Saad","family":"Zaghloul","sequence":"first","affiliation":[{"name":"Radiation Oncology Department National Cancer Institute Cairo University Cairo Egypt"},{"name":"Radiation Oncology Department Children's Cancer Hospital Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mai K.","family":"Bishr","sequence":"additional","affiliation":[{"name":"The Institute of Cancer Research London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amal","family":"Refaat","sequence":"additional","affiliation":[{"name":"Radiology Department National Cancer Institute Cairo University Cairo Egypt"},{"name":"Radiology Department Children's Cancer Hospital Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed El","family":"Hemaly","sequence":"additional","affiliation":[{"name":"Pediatric Oncology Department National Cancer Institute, Cairo University Cairo Egypt"},{"name":"Pediatric Oncology Department Children's Cancer Hospital Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9791-0104","authenticated-orcid":false,"given":"Moatssem Al","family":"Ayadi","sequence":"additional","affiliation":[{"name":"Pediatric Oncology Department National Cancer Institute, Cairo University Cairo Egypt"},{"name":"Pediatric Oncology Department Children's Cancer Hospital Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soha","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Clinical Oncology Department Suez University Suez Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eslam","family":"Maher","sequence":"additional","affiliation":[{"name":"Clinical Research Department Children's Cancer Hospital Cairo 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