What is your treatment approach for a recurrent brainstem glioma?  

Recurrent brainstem glioma is a very challenging situation. One could consider participating in a clinical trial if available, especially one that targets some of the known mutations in the tumor (such as histone h3, TP53, ATRX, ACVR1, and others). We have previously re-irradiated a few patients at ...

This is clearly a complex and challenging condition. The way the question is worded suggests the patient has received radiation at the time of diagnosis. As long as six months or more have passed, I would elect to re-irradiate to a lower dose and a smaller margin.