Mount Sinai Researchers Report Largest Study Supporting Three Courses of Radiation for Children With Deadly Brain Tumor
Largest review to date suggests carefully selected patients with recurrent DIPG may experience longer survival and improved quality of life
Children with one of the deadliest forms of brain cancer may benefit from an additional course of radiation therapy after their disease returns, according to new research from the Icahn School of Medicine at Mount Sinai. The study, published in Practical Radiation Oncology (10.1016/j.prro.2026.06.006), is the first to examine the experience of giving three courses of radiation treatment to patients with diffuse intrinsic pontine glioma (DIPG) that has recurred.
The study combines Mount Sinai's institutional experience with every previously published case from around the world, creating the largest reported experience to date of three-course re-irradiation for this rare pediatric brain tumor. The findings suggest that carefully selected patients may safely receive additional radiation, helping relieve symptoms and potentially extending survival.
"DIPG is one of the most devastating cancers we treat," said senior author Stanislav Lazarev, MD, Associate Professor of Radiation Oncology at the Icahn School of Medicine. "Radiation therapy remains the only treatment consistently shown to help these children. Our study represents the largest reported experience to date and suggests that, in carefully selected patients, a third course of radiation may offer additional symptom relief and valuable time without causing unacceptable side effects."
DIPG is an aggressive tumor that forms in the brainstem, the part of the brain that controls breathing, movement, and other essential functions. The disease primarily affects children between 5 and 10 years old and cannot be removed surgically because of its location. Most children survive only about 12 to 14 months after diagnosis, despite treatment.
Radiation therapy is the standard treatment because it can temporarily slow tumor growth and improve symptoms. As the cancer progresses, some patients receive a second course of radiation. However, physicians have had very little evidence to guide decisions about whether a third course could be beneficial, largely because of concerns that repeated radiation might damage healthy brain tissue.
For the study, Mount Sinai investigators reviewed all published reports of patients who received three courses of radiation for recurrent DIPG and added two patients treated at Mount Sinai. In total, the analysis included 12 patients—the entire published worldwide experience with this approach. Across the group, median survival was 27 months from diagnosis, substantially longer than typically reported for DIPG, and many patients experienced meaningful improvements in neurological symptoms and quality of life following additional radiation treatments.
"Families facing recurrent DIPG have very few treatment options," said first author Lauren Jacobs, MD, a resident physician in Radiation Oncology at the Icahn School of Medicine. "While this approach is not a cure, our findings suggest that additional radiation may help some children feel better and live longer. We hope this work provides physicians with evidence to support informed treatment decisions and serves as the foundation for future clinical trials."
Because the treatment uses standard radiation therapy already available at hospitals around the world, researchers say it could be broadly adopted if larger prospective studies confirm its benefits.
The authors caution that the study was retrospective and included a small number of patients because DIPG is rare. Additional research is needed to identify which patients are most likely to benefit and to establish the safest treatment schedules. The Mount Sinai team plans to develop a prospective clinical study to further evaluate multi-course re-irradiation for recurrent DIPG.
The study was conducted by investigators at the Icahn School of Medicine and did not receive specific external funding.
Full study: https://www.sciencedirect.com/science/article/pii/S1879850026002018?dgcid=author
About the Icahn School of Medicine at Mount Sinai
The Icahn School of Medicine at Mount Sinai is internationally renowned for its outstanding research, educational, and clinical care programs. It is the sole academic partner for the seven member hospitals* of the Mount Sinai Health System, one of the largest academic health systems in the United States, providing care to New York City’s large and diverse patient population.
The Icahn School of Medicine at Mount Sinai offers highly competitive MD, PhD, MD-PhD, and master’s degree programs, with enrollment of more than 1,200 students. It has the largest graduate medical education program in the country, with more than 2,700 clinical residents and fellows training throughout the Health System. The Graduate School of Biomedical Sciences offers 12 degree-granting programs, conducts innovative basic and translational research, and trains more than 470 postdoctoral research fellows.
Ranked 11th nationwide in National Institutes of Health (NIH) funding, the Icahn School of Medicine at Mount Sinai is among the 90th percentile of U.S. private medical schools in Sponsored Programs Direct Expenditures per Principal Investigator, according to the Association of American Medical Colleges. More than 6,900 scientists, educators, and clinicians work within and across dozens of academic departments and multidisciplinary institutes with an emphasis on translational research and therapeutics. Through Mount Sinai Innovation Partners (MSIP), the Health System facilitates the real-world application and commercialization of medical breakthroughs made at Mount Sinai.
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* Mount Sinai Health System member hospitals: The Mount Sinai Hospital; Mount Sinai Brooklyn; Mount Sinai Morningside; Mount Sinai Queens; Mount Sinai South Nassau; Mount Sinai West; and New York Eye and Ear Infirmary of Mount Sinai.
About the Mount Sinai Health System
Mount Sinai Health System is one of the nation’s leading integrated academic health systems and one of the largest in the New York metropolitan area. Its comprehensive system includes seven hospitals, more than 400 outpatient practices, over 600 research and clinical laboratories, the Icahn School of Medicine at Mount Sinai, the Graduate School of Biomedical Sciences, and the Mount Sinai Phillips School of Nursing. Together, the Health System comprises approximately 48,000 employees, more than 9,000 physicians, and 8,600 nurses.
As a leading learning health system, Mount Sinai combines clinical expertise with scientific discovery to improve patient care while training the next generation of health care and biomedical leaders. The Health System provides care across every stage of life, from prenatal care through geriatrics, while advancing personalized medicine through artificial intelligence, data science, and biomedical research.
Mount Sinai is consistently recognized among the nation’s leading academic health systems for patient care, research, and education. The Mount Sinai Hospital is ranked No. 1 in New York by Newsweek and No. 5 on the magazine’s World’s Best Hospitals list. The Icahn School of Medicine at Mount Sinai ranks No. 11 among U.S. medical schools and No. 1 among freestanding medical schools for National Institutes of Health funding, reflecting the strength of its scientific enterprise and leadership in biomedical research.