INTRODUCTION: Diffuse intrinsic pontine glioma (DIPG) is the most common form of 
brainstem glioma. The present study was performed to assess if hypofractionated 
radiotherapy completed in < 3 weeks with temozolomide improves survival in DIPG.
MATERIAL AND METHODS: The present study is a phase II open label randomized 
trial. The study included newly diagnosed patients with DIPG. Patients in arm A 
received conventional fractionated RT of 60 Gy in 30 fractions over 6 weeks 
while patients in arm B received hypo-fractionated radiotherapy of 39 Gy in 13 
fractions over 2.6 weeks along with concurrent Temozolomide (TMZ) 75 mg/m2 from 
day 1 to day 17 followed by adjuvant TMZ for six cycles. The survival analysis 
was performed with modified intention to treat analysis.
RESULTS: A total of 35 patients were randomized. 33 patients were evaluable. 93% 
(n = 14) of patients in the conventional arm completed treatment while only 17% 
(n = 3) of the children could complete planned course of treatment in the 
experimental arm. The median overall survival (OS) was 11 months (95% CI - 7.5 
to 14.5 months) in the conventional arm and 12 months (95% CI - 10.5 to 
13.5 months) in the experimental arm (p = 0.208). 28% (n = 5) patients in the 
experimental arm developed grade 3 or 4 hematological toxicity.
CONCLUSION: The above study shows that hypofractionated radiotherapy with 
concurrent and adjuvant temozolomide does not improve OS and has higher 
hematological toxicity. Conventional radiotherapy remains the standard of care.