Prolonged survival in pediatric diffuse intrinsic pontine glioma following intensity-modulated radiation therapy: a case report.

BACKGROUND

The aggressive WHO grade IV brainstem tumors known as diffuse intrinsic pontine gliomas (DIPGs) primarily strike children between the ages of 5 and 10. Because they are incurable, their median survival is less than a year. While traditional radiation provides short-term discomfort alleviation, more sophisticated methods like as intensity-modulated radiation therapy (IMRT) have demonstrated potential for enhancing tumor targeting and lowering treatment-related side effects.

CASE PRESENTATION: A 9-year-old Indian male with persistent headaches and vomiting was diagnosed with diffuse intrinsic pontine glioma (DIPG) after a large, non-enhancing, altered signal intensity lesion was found in his brain. The lesion was hyperintense on T2WI/fluid-attenuated inversion recovery (FLAIR) and hypointense on T1WI, causing significant mass effect and resulting in obstructive hydrocephalus. The patient underwent ventriculoperitoneal shunting to relieve hydrocephalus, but a postoperative computed tomography (CT) showed a hypodense lesion extending from the thalami to the pons. The patient was scheduled for definitive intensity-modulated radiation therapy (IMRT) to a total dose of 54 Gy in 30 fractions, initiated on December 20, 2022, and completed by January 30, 2023. Supportive medications were continued post-treatment.

CONCLUSION

The case report highlights prolonged survival in a pediatric DIPG patient following IMRT, highlighting the potential for improved outcomes with modern radiation techniques. Future research should focus on therapy predictors and treatment integration.