再程放疗联合 CDK4/6 抑制剂治疗儿童复发 弥漫内生型脑桥胶质瘤的真实世界研究.

ObjectiveTo explore the efficacy of reirradiation (re-RT) for recurrent pediatric diffuse intrinsic pontine glioma (DIPG) in China and preliminarily explore the impact of concurrent re-RT with ribociclib on the prognosis of DIPG patients. MethodsA total of 18 children with recurrent DIPG who received re-RT with or without ribociclib were recruited from Department of Oncology, Guangdong Sanjiu Brain Hospital from May 2021 to May 2023.Common Terminology Criteria for Adverse Events (CTCAE 4.0) was utilized for evaluating the occurrences of adverse reactions.Kaplan-Meier method was employed for calculating overall survival and Log-rank for examining the survival difference between two groups. ResultsThere were 5 boys and 13 girls with a median age of 7.0 years.Seven patients received concurrent reirradiation and ribociclib.Median interval between upfront radiotherapy and re-RT was 9.0 months.Among well-documented patients, 64.3%(9/14) had relieved extremity weakness, 62.5%(5/8) had improvement in slurred speech, 50% (3/6) had better walking instability and 77.8%(14/18) had tumor regression.Median survival was 4.7 months from a start of re-RT to death and overall median survival 18.6 months from an initial diagnosis.No significant difference existed in median overall survival (17.2 months vs.18.9 months)or median survival from a start of re-RT to death (6.2 months vs.5.4 months) in patients receiving re-RT plus ribociclib as compared with those without ribociclib, with P values of 0.714 and 0.390, respectively.Among 7 children receiving concurrent re-RT and ribociclib, 3 patients (42.9%) experienced hematological adverse events of CTCAE grade 1, 2 and 3. ConclusionsRe-RT may improve clinical symptoms and prolong survival time in children with recurrent DIPG.Concurrent re-RT and ribociclib therapy not only don't improve survival but also increase toxicity in children with DIPG. [ABSTRACT FROM AUTHOR]