title: Temozolomide in the treatment of newly diagnosed diffuse brainstem glioma in children: a broken promise?
abstract: BACKGROUND
  The purpose of this study was to assess the efficacy and toxicity of radiotherapy (RT) with concurrent temozolomide (TMZ) chemotherapy followed by adjuvant TMZ in children with diffuse intrinsic pontine glioma (DIPG).
  
  
  METHODS
  Patients younger than 18 years with newly diagnosed DIPG were enrolled. Children were treated with focal RT along with concurrent daily TMZ. Four weeks after completing the initial RT-TMZ schedule, adjuvant TMZ was given every 28 days up to 12 cycles or progression disease.
  
  
  RESULTS
  Fifteen children with a median age of 9 years were enrolled. Fourteenth out of the 15 patients completed the chemoradiotherapy. The toxicity associated with TMZ was primarily haematopoietic. At a median follow-up of 15 months 13 children had died and 2 children were alive with progressive disease. No patient experienced complete response (CR). The median time to progression was 7.15 months.
  
  
  CONCLUSIONS
  Chemoradiotherapy with TMZ followed by adjuvant TMZ did not improve the poor prognosis associated with DIPG in children.
authors.forename: Daniela
authors.initials: D
authors.lastname: Rizzo
authors.forename: Maria
authors.initials: M
authors.lastname: Scalzone
authors.forename: Antonio
authors.initials: A
authors.lastname: Ruggiero
authors.forename: Palma
authors.initials: P
authors.lastname: Maurizi
authors.forename: Giorgio
authors.initials: G
authors.lastname: Attinà
authors.forename: Stefano
authors.initials: S
authors.lastname: Mastrangelo
authors.forename: Ilaria
authors.initials: I
authors.lastname: Lazzareschi
authors.forename: Vita
authors.initials: V
authors.lastname: Ridola
authors.forename: Cesare
authors.initials: C
authors.lastname: Colosimo
authors.forename: Massimo
authors.initials: M
authors.lastname: Caldarelli
authors.forename: Mario
authors.initials: M
authors.lastname: Balducci
authors.forename: Riccardo
authors.initials: R
authors.lastname: Riccardi
mesh_terms: D000293:Adolescent; D018906:Antineoplastic Agents, Alkylating / Q000009:adverse effects / Q000627:therapeutic use*; D001933:Brain Stem / Q000187:drug effects* / Q000473:pathology / Q000528:radiation effects; D020295:Brain Stem Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D003606:Dacarbazine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005910:Glioma / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy; D016519:Hospitals, Religious; D006785:Hospitals, University; D006801:Humans; D008297:Male; D060787:Neoplasm Grading; D009474:Neurons / Q000187:drug effects* / Q000473:pathology / Q000528:radiation effects; D011379:Prognosis; D011446:Prospective Studies; D012384:Rome; D016019:Survival Analysis; D000077204:Temozolomide
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide
keywords: Children,; Diffuse intrinsic pontine glioma; Temozolomide,