{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T11:05:19Z","timestamp":1789643119452,"version":"4.0.0"},"reference-count":7,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Key Project of Natural Science Foundation of Zhejiang Province","award":["LZ25H160003"],"award-info":[{"award-number":["LZ25H160003"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Adult brainstem gliomas (BSGs) are rare malignant tumors of the central nervous system (CNS) that are difficult to resect completely via surgery, so chemoradiotherapy (CRT) is the primary treatment modality. However, there is substantial interpatient variability in therapeutic response to CRT among patients with BSGs. Here we present a case of a 41-year-old man who had experienced right limb weakness for 3 months. Brain MRI showed a solid-cystic mass in the brainstem, involving the medulla oblongata and the cervical spinal cord. The pathological diagnosis was pilocytic astrocytoma, CNS WHO Grade 1. Since the solid-cystic mass in the brainstem was unresectable, the patient received concurrent CRT followed by temozolomide (TMZ) maintenance chemotherapy. No significant change in tumor size was observed after concurrent CRT. Notably, 15 months after radiotherapy (19 months since the initial diagnosis), the tumor size decreased significantly. Up to the latest follow-up, the patient has maintained sustained partial remission.<\/jats:p>","DOI":"10.3390\/diagnostics16183011","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T09:59:03Z","timestamp":1789639143000},"page":"3011","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Delayed Imaging Response After Chemoradiotherapy in a Patient with Unresectable Brainstem Pilocytic Astrocytoma"],"prefix":"10.3390","volume":"16","author":[{"given":"Yan","family":"Shen","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3597-7784","authenticated-orcid":false,"given":"Chao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fengbo","family":"Huang","sequence":"additional","affiliation":[{"name":"Key Laboratory of Cancer Prevention and Intervention, National Ministry of Education, Cancer Institute, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou 310009, China"},{"name":"Department of Pathology, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou 310009, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Qian","sequence":"additional","affiliation":[{"name":"Department of Radiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou 310009, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6002-8000","authenticated-orcid":false,"given":"Bicheng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China"},{"name":"Key Laboratory of Cancer Prevention and Intervention, National Ministry of Education, Cancer Institute, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou 310009, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2044-2610","authenticated-orcid":false,"given":"Ting","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China"},{"name":"Key Laboratory of Cancer Prevention and Intervention, National Ministry of Education, Cancer Institute, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou 310009, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3202-6470","authenticated-orcid":false,"given":"Dang","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China"},{"name":"Key Laboratory of Cancer Prevention and Intervention, National Ministry of Education, Cancer Institute, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou 310009, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1007\/s11060-014-1434-1","article-title":"Clinical management and outcome of histologically verified adult brainstem gliomas in Switzerland: A retrospective analysis of 21 patients","volume":"118","author":"Hundsberger","year":"2014","journal-title":"J. Neurooncol."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Reithmeier, T., Kuzeawu, A., Hentschel, B., Loeffler, M., Trippel, M., and Nikkhah, G. (2014). Retrospectiveanalysis of 104 histologically proven adult brainstem gliomas: Clinical symptoms, therapeutic approaches and prognostic factors. BMC Cancer, 14.","DOI":"10.1186\/1471-2407-14-115"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"12","DOI":"10.6004\/jnccn.2023.0002","article-title":"NCCN Guidelines(R) Insights: Central Nervous System Cancers, Version 2.2022","volume":"21","author":"Horbinski","year":"2023","journal-title":"J. Natl. Compr. Cancer Netw."},{"key":"ref_4","unstructured":"Neurosurgery Oncology Group of the Chinese Medical Association (2017). Chinese Expert Consensus on the Comprehensive Diagnosis and Treatment of Brainstem Gliomas. Natl. Med. J. China, 97, 13."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Liu, Z.Y., Feng, S.S., Li, J., Cao, H., Huang, J., Fan, F., Cheng, L., Liu, Z., and Cheng, Q. (2021). The survival benefits of surgical resection and adjuvant therapy for patients with brainstem glioma. Front. Oncol., 11.","DOI":"10.3389\/fonc.2021.566972"},{"key":"ref_6","first-page":"1","article-title":"Clinical Characteristics and Prognosis of Adult Brainstem Gliomas: A Retrospective Analysis of 81 Patients from a Single Center Over 10 Years","volume":"19","author":"Zhou","year":"2022","journal-title":"J. Clin. Neurosurg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"12","DOI":"10.25259\/SNI_594_2020","article-title":"Chemotherapy-induced changes in tumor consistency can allow gross total resection of previously unresectable brainstem pilocytic astrocytoma","volume":"12","author":"Chung","year":"2021","journal-title":"Surg. Neurol. Int."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/18\/3011\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T10:27:56Z","timestamp":1789640876000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/18\/3011"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,17]]},"references-count":7,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["diagnostics16183011"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics16183011","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,17]]}}}