{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:51:58Z","timestamp":1787316718266,"version":"build-2736575974"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2021,1,30]],"date-time":"2021-01-30T00:00:00Z","timestamp":1611964800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,4,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>We present our institutional approach for re-irradiation in diffuse intrinsic pontine glioma and their outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Consecutive patients of recurrent diffuse intrinsic pontine glioma treated with re-irradiation (January 2015\u2013September 2019) were reviewed retrospectively to describe the clinical-response-based approach followed for the dose and volume decision. Outcomes were defined with clinical and steroid response criteria and survival endpoints included progression-free survival and overall survival as cumulative(c) overall survival and re-irradiation overall survival (re-irradiation starting to death). The Kaplan\u2013Meier method and log-rank test were used for survival analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-patient cohort with a median (m) age of 7.5\u00a0years, m-progression-free survival of 8.4\u00a0months and m-Lansky performance score of 50 received re-irradiation of which 17 (85%) were called clinical responders. The median re-irradiation-overall survival with 39.6\u201341.4, 43.2 and 45\u00a0Gy were 5.8, 7 and 5.3\u00a0months, respectively. One-month post-re-irradiation steroid independent status was a significant predictor of better survival outcomes (overall survival, P\u22640.004). No \u2265 grade 3 toxicities were noticed. Two patients succumbed to intra-tumoral hemorrhage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Higher doses of re-irradiation based on a clinical-response-based approach show improvement in survival and steroid dependence rates with acceptable toxicity. Steroid independent status at 1-month post-re-irradiation predicts better outcomes. Prospective studies may validate this with quality of life data.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jjco\/hyab006","type":"journal-article","created":{"date-parts":[[2021,1,8]],"date-time":"2021-01-08T15:44:11Z","timestamp":1610120651000},"page":"762-768","source":"Crossref","is-referenced-by-count":16,"title":["Clinical approach to re-irradiation for recurrent diffuse intrinsic pontine glioma"],"prefix":"10.1093","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4511-7782","authenticated-orcid":false,"given":"Rahul","family":"Krishnatry","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Tata Memorial Centre (TMH\/ACTREC), Mumbai, India"},{"name":"Homi Bhabha National Institute (HBNI), Mumbai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jifmi Jose","family":"Manjali","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Tata Memorial Centre (TMH\/ACTREC), Mumbai, India"},{"name":"Homi Bhabha National Institute (HBNI), Mumbai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Girish","family":"Chinnaswamy","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology, Tata Memorial Centre (TMH\/ACTREC), Mumbai, India"},{"name":"Homi Bhabha National Institute (HBNI), Mumbai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhishek","family":"Chatterjee","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Tata Memorial Centre (TMH\/ACTREC), Mumbai, India"},{"name":"Homi Bhabha National Institute (HBNI), Mumbai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayant Sastri","family":"Goda","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Tata Memorial Centre (TMH\/ACTREC), Mumbai, India"},{"name":"Homi Bhabha National Institute (HBNI), Mumbai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Janu","sequence":"additional","affiliation":[{"name":"Department of Radiology, Tata Memorial Centre (TMH\/ACTREC), Mumbai, India"},{"name":"Homi Bhabha National Institute (HBNI), Mumbai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arpita","family":"Sahu","sequence":"additional","affiliation":[{"name":"Department of Radiology, Tata Memorial Centre (TMH\/ACTREC), Mumbai, India"},{"name":"Homi Bhabha National Institute (HBNI), Mumbai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rakesh","family":"Jalali","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Tata Memorial Centre (TMH\/ACTREC), Mumbai, India"},{"name":"Homi Bhabha National Institute (HBNI), Mumbai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tejpal","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Tata Memorial Centre (TMH\/ACTREC), Mumbai, India"},{"name":"Homi Bhabha National Institute (HBNI), Mumbai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,1,30]]},"reference":[{"key":"2021043010523540200_ref1","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.ijrobp.2009.04.031","article-title":"Prospective evaluation of radiotherapy with concurrent and adjuvant temozolomide in children with newly diagnosed diffuse intrinsic pontine glioma","volume":"77","author":"Jalali","year":"2010","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"2021043010523540200_ref2","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1517\/14712598.2011.546341","article-title":"Nimotuzumab for pediatric diffuse intrinsic pontine gliomas","volume":"11","author":"Massimino","year":"2011","journal-title":"Expert Opin Biol Ther"},{"key":"2021043010523540200_ref3","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1007\/s11060-008-9525-5","article-title":"Diffuse pontine gliomas in children: changing strategies, changing results? 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