Hypofractionated conformal radiotherapy for pediatric diffuse intrinsic pontine glioma (DIPG): A randomized controlled trial

Mohamed S. Zaghloul, Eman Eldebawy, Soha Ahmed, Amr G. Mousa, Amr Amin, Amal Refaat, Iman Zaky, Nada Elkhateeb, Mohamed Sabry

Research output: Contribution to journalArticlepeer-review

66 Citations (Scopus)


Background The pediatric diffuse intrinsic pontine glioma (DIPG) outcome remains dismal despite multiple therapeutic attempts. Purpose To compare the results of treatment of pediatric diffuse intrinsic pontine glioma (DIPG) using hypofractionated versus conventional radiotherapy. Patients and methods Seventy-one newly diagnosed DIPG children were randomized into hypofractionated (HF) (39 Gy/13 fractions in 2.6 weeks) and conventional (CF) arm (54 Gy/30 fractions in 6 weeks). Results The median and one-year overall survival (OS) was 7.8 months and 36.4 ± 8.2% for the hypofractionated arm, and 9.5 and 26.2 ± 7.4% for the conventional arm respectively. The 18-month OS difference was 2.2%. The OS hazard ratio (HR) was 1.14 (95% CI: 0.70-1.89) (p = 0.59). The hypofractionated arm had a median and one-year progression-free survival (PFS) of 6.6 months and 22.5 ± 7.1%, compared to 7.3 and 17.9 ± 7.1% for the conventional arm. The PFS HR was 1.10 (95% CI: 0.67-1.90) (p = 0.71). The 18-month PFS difference was 1.1%. These differences exceed the non-inferiority margin. The immediate and delayed side effects were not different in the 2 arms. Conclusions Hypofractionated radiotherapy offers lesser burden on the patients, their families and the treating departments, with nearly comparable results to conventional fractionation, though not fulfilling the non-inferiority assumption.

Original languageEnglish
Pages (from-to)35-40
Number of pages6
JournalRadiotherapy and Oncology
Issue number1
Publication statusPublished - Apr 2014
Externally publishedYes


  • DIPG
  • Diffuse intrinsic pontine glioma
  • Hypofractionation
  • Overall and progression-free survival

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Radiology Nuclear Medicine and imaging


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