2026 Volume 63 Issue 2 Pages 164-171
Diffuse intrinsic pontine glioma (DIPG) is a pediatric brainstem tumor with poor prognosis. Recently, new treatment and evaluation methods, such as hypofractionated radiation therapy (HFRT) and radiomic analysis, have been reported. This retrospective, single-center study involving 27 patients with DIPGs investigated the efficacy of HFRT and examined prognostic factors using radiomic analysis. Efficacy endpoints were overall survival (OS) and progression-free survival (PFS). Patient background and radiomic features were evaluated as prognostic factors affecting OS. Eleven patients were men, the median age at diagnosis was 6.2 years, and 23 received HFRT. Median OS in the HFRT and conventional fractionated radiation therapy (CFRT) groups was 9.0 and 9.6 months, respectively. Tumor size (continuous variable) was the only significant patient background factor related to OS, and in the three subgroups by tumor size, OS was longer in the large tumor size group. Contrastingly, no radiomic features were significantly associated with OS. The OS of patients who received HFRT was similar to that of patients who received CFRT. Choosing HFRT as the initial treatment, which can reduce the treatment duration by one month, reduced the burden on the patients. Tumor size at diagnosis was related to OS, but radiomics features based on magnetic resonance images were not. The need to identify prognostic factors for DIPG is high and further research is warranted.
