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. 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. 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.
Telkhade et al. (Mon,) studied this question.