Diffuse intrinsic pontine gliomas in pediatric patients: management updates

IF 0.7 Q4 CLINICAL NEUROLOGY Egyptian journal of neurosurgery Pub Date : 2023-11-14 DOI:10.1186/s41984-023-00242-9
Caroline Davidson, Samuel Woodford, Daisy Valle, Grace Parker, Ann-Marie Derias, Carina Copley, Brandon Lucke-Wold
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Abstract

Abstract Background This review explores how diffuse intrinsic pontine glioma (DIPG) diagnosis and treatment have evolved and are improving. Main body Authors used various sources from 2000 to present time to compile information on diffuse intrinsic pontine glioma in the pediatric population. The following topics were included: diagnosis procedure, molecular analysis, stereotactic biopsy, radiation therapy and other treatments. Historically, diffuse intrinsic pontine glioma’s anatomical proximity to crucial brain stem structures prevented biopsy thus limiting diagnostic and molecular analysis. However, with the optimistic rise of the stereotactic biopsy technique, identifying genetic and other biological markers for targeted treatments is more feasible. Previous investigations have identified a histone mutation that appears in 80% of DIPG cases and there is plenty of exploration into how to unravel the effects of the resulting chromatin modification. For example, new pharmaceuticals like Panobinostat and ONC201 show promise. Conclusion Advances in stereotactic biopsy technology have resulted in more accurate diagnosis opening more avenues for molecular analysis and thus, targeted treatments. DIPG requires more exploration to improve outcomes for patients.
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小儿弥漫性内生性脑桥胶质瘤:治疗进展
本文综述了弥漫性内禀脑桥胶质瘤(DIPG)的诊断和治疗方法的发展和改进。作者使用2000年至今的各种来源来汇编儿童人群弥漫性内生性脑桥胶质瘤的信息。以下主题包括:诊断程序,分子分析,立体定向活检,放射治疗和其他治疗。从历史上看,弥漫性内在脑桥胶质瘤在解剖学上接近关键的脑干结构,因此无法进行活检,从而限制了诊断和分子分析。然而,随着立体定向活检技术的兴起,识别基因和其他生物标记物进行靶向治疗变得更加可行。先前的研究已经确定了在80%的DIPG病例中出现的组蛋白突变,并且对如何揭示由此产生的染色质修饰的影响进行了大量的探索。例如,像Panobinostat和ONC201这样的新药显示出希望。结论立体定向活检技术的进步使诊断更加准确,为分子分析开辟了更多的途径,从而有针对性地治疗。DIPG需要更多的探索来改善患者的预后。
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