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Updated: Aug 5, 2026
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Live-3D-Cell Immunocytochemistry Assays of Pediatric Diffuse Midline Glioma
Published on: November 11, 2021
Re-Irradiation in Pediatric Diffuse Midline Glioma: A Multi-Institutional Retrospective Study
Ajay Thomas Alex1, Sean P Hassan1,2,3, Helen Benghiat4
1Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.
Pediatric Blood & Cancer
|July 29, 2026
Summary
Re-irradiation (RT2) significantly improves survival for children with recurrent diffuse midline gliomas (DMGs). This salvage therapy offers a crucial benefit for patients with limited options after initial treatment.
Area of Science:
- Pediatric Oncology
- Radiation Oncology
- Neuro-oncology
Background:
- Recurrent diffuse midline gliomas (DMGs) in children present limited therapeutic options.
- The benefit of re-irradiation (RT2) at progression remains uncertain.
Purpose of the Study:
- To evaluate the survival benefit of re-irradiation (RT2) in children with recurrent diffuse midline gliomas (DMGs).
Main Methods:
- A multi-institutional retrospective study included 167 children (<18 years) with DMG who experienced radiologic progression after initial radiation (RT1).
- Overall survival (OS) was analyzed from the date of progression using Kaplan-Meier and multivariable Cox regression.
Main Results:
- Children receiving RT2 had a longer interval from RT1 to progression and significantly longer median OS (0.59 years) compared to those not receiving RT2 (0.21 years).
- Six-month OS was 68% with RT2 versus 16% without; 1-year OS was 19% versus 3%.
- RT2 was the strongest independent predictor of survival (HR 0.29, p<0.0001).
Conclusions:
- Re-irradiation (RT2) demonstrates a significant survival benefit for children with recurrent diffuse midline gliomas (DMGs).
- RT2 should be considered a key component of salvage therapy for pediatric DMG patients.
- Longer intervals between RT1 and RT2 were associated with superior survival outcomes.
