Haematotoxicity of craniospinal radiochemotherapy for metastatic paediatric high-grade glioma
Aims - Paediatric high-grade gliomas (pedHGGs) have a dismal prognosis, often characterised by early and diffuse disease progression. Novel treatment approaches are urgently needed to improve outcomes. The upcoming SIOPE-HGG (High Grade Glioma)-01 trial will investigate upfront craniospinal radioche...
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| Hauptverfasser: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
December 2025
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| In: |
Clinical oncology
Year: 2025, Jahrgang: 48, Pages: 1-8 |
| ISSN: | 1433-2981 |
| DOI: | 10.1016/j.clon.2025.103956 |
| Online-Zugang: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.clon.2025.103956 Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S0936655525002110 
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| Verfasserangaben: | C. Valentini, T. Perwein, B. Bison, G.H. Gielen, F. Knerlich-Lukoschus, H.C. Bock, C. Seidel, R.D. Kortmann, D. Sturm, M. Benesch, G. Nussbaumer, J.M. Krischer, A.O. von Bueren, M. Eyrich, L.L. Friker, M. Hoffmann, E. Gkika, A. Wittig-Sauerwein, J. Hörner-Rieber, R. Schwarz, K. Jablonska, W. Hoffmann, D. Vordermark, S. Rieken, L. Höng, C. Rödel, B. Timmermann, J.T. Fennell, A. Claviez, M. Karremann, C.M. Kramm, M. Krause |
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| 100 | 1 | |a Valentini, Chiara |d 1983- |e VerfasserIn |0 (DE-588)1268053619 |0 (DE-627)1816652245 |4 aut | |
| 245 | 1 | 0 | |a Haematotoxicity of craniospinal radiochemotherapy for metastatic paediatric high-grade glioma |c C. Valentini, T. Perwein, B. Bison, G.H. Gielen, F. Knerlich-Lukoschus, H.C. Bock, C. Seidel, R.D. Kortmann, D. Sturm, M. Benesch, G. Nussbaumer, J.M. Krischer, A.O. von Bueren, M. Eyrich, L.L. Friker, M. Hoffmann, E. Gkika, A. Wittig-Sauerwein, J. Hörner-Rieber, R. Schwarz, K. Jablonska, W. Hoffmann, D. Vordermark, S. Rieken, L. Höng, C. Rödel, B. Timmermann, J.T. Fennell, A. Claviez, M. Karremann, C.M. Kramm, M. Krause |
| 246 | 1 | |i Online verfügbar |a 11. Oktober 2025, Artikelversion: 8. November 2025 | |
| 264 | 1 | |c December 2025 | |
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| 520 | |a Aims - Paediatric high-grade gliomas (pedHGGs) have a dismal prognosis, often characterised by early and diffuse disease progression. Novel treatment approaches are urgently needed to improve outcomes. The upcoming SIOPE-HGG (High Grade Glioma)-01 trial will investigate upfront craniospinal radiochemotherapy (CSI-RCT) for newly diagnosed, nonmetastatic diffuse midline glioma/diffuse intrinsic pontine glioma (DMG/DIPG). As CSI-RCT is frequently avoided due to concerns over haematotoxicity, real-world feasibility data are critically needed. - Materials and methods - We retrospectively assessed haematological toxicity in 19 patients (aged 3-21 years) with metastatic pedHGG treated with CSI-RCT within the hirn tumor glioblastoma trial (HIT-HGG) and hospital in trial-glioblastoma (HIT-GBM) trial programmes (2002-2024). All patients received craniospinal irradiation (median dose: 35.2 Gy) using photon- or proton-based techniques, with concurrent chemotherapy: temozolomide (TMZ; n = 14) or PEI (cisplatin, etoposide, ifosfamide; n = 5). Haematological toxicities were graded according to Common Terminology Criteria for Adverse Events (CTCAE) v4.0. - Results - Grade 3 to 4 haematotoxicity was observed in 7 of 19 patients (36.8%). Chemotherapy was discontinued in two cases—one due to TMZ-induced aplastic anaemia (TIAA) and another due to thrombocytopaenia. The remaining patients tolerated full-dose CSI-RCT with manageable side effects, and no unplanned radiotherapy interruptions occurred. The haematotoxicity rate was comparable to or lower than previous reports, indicating that CSI-RCT is feasible with appropriate monitoring and management. - Conclusion - This is the largest cohort to date assessing haematological toxicity of upfront CSI-RCT in metastatic pedHGG. Despite notable haematotoxicity, treatment was largely feasible and well-tolerated. These findings support the integration of CSI-RCT into future clinical trials for newly diagnosed DMG/DIPG and provide a foundation for the upcoming SIOPE HGG-01 trial. Proton therapy may further reduce toxicity and warrants prospective evaluation. | ||
| 650 | 4 | |a Craniospinal radiochemotherapy | |
| 650 | 4 | |a haematotoxicity | |
| 650 | 4 | |a paediatric high-grade glioma | |
| 700 | 1 | |a Perwein, T. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Bison, B. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Gielen, G. H. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Knerlich-Lukoschus, F. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Bock, H. C. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Seidel, C. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Kortmann, R. D. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Sturm, D. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Benesch, M. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Nussbaumer, G. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Krischer, J. M. |e VerfasserIn |4 aut | |
| 700 | 1 | |a von Bueren, A. O. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Eyrich, M. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Friker, L. L. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Hoffmann, M. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Gkika, E. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Wittig-Sauerwein, A. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Hörner-Rieber, J. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Schwarz, R. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Jablonska, K. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Hoffmann, W. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Vordermark, Dirk |d 1969- |e VerfasserIn |0 (DE-588)120828650 |0 (DE-627)080912192 |0 (DE-576)292405197 |4 aut | |
| 700 | 1 | |a Rieken, S. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Höng, L. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Rödel, C. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Timmermann, B. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Fennell, J. T. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Claviez, A. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Karremann, Michael |d 1975- |e VerfasserIn |0 (DE-588)129089192 |0 (DE-627)389523534 |0 (DE-576)166957968 |4 aut | |
| 700 | 1 | |a Kramm, C. M. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Krause, M. |e VerfasserIn |4 aut | |
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