Dipg-80. Imaging Characteristics in Pediatric Patients With Diffuse Intrinsic Pontine Glioma and Outcome: The Md Anderson Cancer Center Experience

Abstract BACKGROUND Diffuse intrinsic pontine glioma (DIPG) occurs exclusively in children and, although rare, carries a poor prognosis with a median survival of approximately 10 months. Diagnosis is made on clinical and radiological appearance of the tumor. The treatment for DIPG is radiation therapy, but it is inadequate as most patients experience rapid progression and succumb to the disease. Our study sought to review radiological characteristics and survival outcomes in pediatric DIPG patients at MD Anderson Cancer Center to better understand imaging and improve current DIPG management. METHODS We performed a retrospective review of demographic and clinical data of patients with radiographic diagnosis of DIPG from 2006-2019, with IRB approval. The patients included in this study were treated at The University of Texas MD Anderson Cancer Center. Imaging findings upon diagnosis of DIPG, including the presence of hydrocephalus, intratumoral bleeding, contrast enhancement, and necrosis, were correlated with survival using Kaplan-Meier methods RESULTS This study included 25 patients diagnosed with DIPG via MRI imaging. The median OS was 13.7 months and median PFS was 10 months for this cohort. At diagnosis, if the patient had hydrocephalus or intratumoral bleeding, the median PFS were shorter compared with those who did not (8.5 and 5.4 months vs 12.2 and 10.8 months; Log-rank, P=0.019 and P=0.029, respectively). Other imaging findings, including contrast enhancement (CE) or presence of necrosis, are trending toward worse outcomes (CE vs no CE: PFS 7.9 vs 11.1 months, P=0.10; necrosis vs no necrosis: PFS 5.2 vs 10.5 months, P=0.78, respectively) CONCLUSION Imaging characteristics at diagnosis can be predictive of outcome. Hence, we propose to consider early interventions for these subgroups with worse outcomes to proceed with shunt placement and early enrollment for clinical trials as feasible. To further validate these findings, a large prospective study is required.