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Updated: Aug 9, 2026
A Protocol for Rapid Post-mortem Cell Culture of Diffuse Intrinsic Pontine Glioma (DIPG)
Published on: March 7, 2017
Treatment options in childhood pontine gliomas
Sabine Wagner1, Monika Warmuth-Metz, Angela Emser
1Department of Pediatric Oncology, Krankenhaus der Barmherzigen Brüder Klinik St. Hedwig, Regensburg, Germany. sabine.wagner@barmherzige-regensburg.de
Insights
Pontine gliomas have a poor prognosis, but intensive treatment can improve survival. Irradiation and chemotherapy are key elements in managing these pediatric brain tumors, offering better overall survival rates.
Area of Science:
- Pediatric Oncology
- Neuro-oncology
- Clinical Research
Background:
- Pontine gliomas represent a challenging subgroup of brainstem gliomas with a historically poor prognosis.
- Treatment strategies for pontine gliomas remain a subject of debate within the medical community.
Purpose of the Study:
- To analyze prognostic factors in pediatric pontine gliomas.
- To evaluate the impact of intensive treatment modalities on patient survival.
Main Methods:
- Data from 153 children with pontine gliomas treated in multi-center studies (1983-2001) were pooled from the HIT-GBM database.
- Statistical analyses included contingency tables, Kaplan-Meier curves, and Cox regression to assess prognostic factors and treatment relevance.
- Prognostic factors and the effectiveness of resection, irradiation, and chemotherapy were investigated.
Main Results:
- The one-year overall survival rate for all patients was 39.9%.
- Favorable prognostic indicators included younger age (<4 years), low-grade histology, and smaller tumor size.
- Both irradiation and chemotherapy demonstrated prognostic relevance; chemotherapy showed a significant benefit in irradiated patients (1YOS 45.8% vs. 34.4%, P=0.030).
Conclusions:
- Irradiation is an effective component in the treatment of pontine gliomas.
- Intensive chemotherapy plays a crucial role in improving overall survival for patients with pontine gliomas.
Background:
Pontine gliomas are the subgroup of brainstem gliomas with the worst prognosis. Controversial treatment approaches are discussed.
Patients And Methods:
Data of children with pontine gliomas treated in different prospective multi-center studies who were registered in the HIT-GBM database were pooled and analyzed addressing prognostic factors and the relevance of intensive treatment using contingency tables, Kaplan-Meier curves and Cox regression analyses.
Results:
From 1983 to 2001, 153 patients (74 males, 79 females, mean age: 8.1 years) with pontine gliomas were registered. Twenty-one tumors were low-grade and 60 were high-grade gliomas (72 undefined histology: 67 no surgery, 5 incomplete data). Sixteen tumors were partially resected, and 125 were irradiated. Ninety children received chemotherapy according to the "HIT-GBM" protocols ("Hirntumor-Glioblastoma multiforme"). The one-year overall survival rate (1YOS) of all patients with pontine glioma was 39.9+/-4.3%. None of the surviving patients had an observation time longer than 3.9 years. Favorable prognostic factors seemed to be age younger than 4 years, low-grade histology and smaller tumor. All three major treatment modalities including resection, irradiation and chemotherapy had prognostic relevance in univariable analysis. Chemotherapy remained beneficial, even if the analysis was restricted to the subgroup of irradiated tumors (1YOS 45.8+/-5.4% vs. 34.4+/-13.5%, P=0.030).
Conclusion:
Irradiation is an effective element for the treatment of pontine gliomas. Intensive chemotherapy seems to be important in achieving a better OS.
