The REMIT (RE-irradiation of diffuse MIdline glioma paTients) study evaluates safety and the palliative efficacy of re-irradiation of patients with diffuse midline glioma (DMG). The study will introduce a standard re-irradiation treatment schedule for DMG patients who have progressed following primary treatment.
Who can participate
Age range12 Months – 21 Years
SexALL
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AI-rewrites the medical criteria so a patient or caregiver can understand them. Always confirm with the trial site.
Inclusion Criteria:
* Diffuse midline glioma diagnosis: verified radiologically or histologically Biopsy is not mandatory for REMIT
* Age ≥ 12 months to ≤21 years.
* Min. 180 days/6 months have elapsed from the first day of the 1st RT course
* 1st course of radiotherapy
* Full recovery from all acute and subacute toxicities of 1st RT course
* Clinical progression of symptoms and/or radiographic progression
* Karnofsky performance status scale or Lansky Play Scale \> 50% The performance status should not take the neurological deficits per se into account.
NB: Children and adults with a worsening performance status due to glioma-related motor deficit can be included.
* Life expectancy \> 12 weeks after start of reRT
* Signed informed consent by patient and/or parents or legal guardian
Exclusion Criteria:
* Presence of leptomeningeal spread or multifocal disease on MRI at progression
* Other co-morbidity that according to the treating physician would impair participation in the study
* \>1 course of radiotherapy
* Neurofibromatosis type 1
* Inability to complete the medical follow-up (geographic, social, or mental reasons)