Does Simultaneous Intensity Modulated Radiotherapy with Temozolomide Increase the Radiosensitivity of Childhood Diffuse Intrinsic Pontine Glioma (DIPG)?- a Clinical Case from our Practice

Diffuse intrinsic pontine glioma (DIPG} is a high-grade glioma (HGG) that originates in the pons and is seen almost exclusively in children. The healing results achieved after a self -conducted conventional, hyperfractionated and hypofractionated radiotherapy (RT) up to a total tumor dose of 54 Gy at DIPG are unfavorable. We present our observations in a child with a locally advanced DIPG after a conventional concomitant Temozolomide radiotherapy. In order to increase the survival in this clinical case, we decided to conduct a simultaneous Temozolomide RT with an extended target volume with the inclusion of the ventricles. Two months after the Temozolomide intensity modulated radiotherapy (IMRT), the MRI reports a reduction in the tumor with a pronounced tumor necrosis, which is evidence of the radio -sensitization effect of Temosolomide.