It is of interest to determine whether COX-2 inhibitors given with radiation therapy can prolong the progression-free survival in brain stem glioma. Diffuse pontine brainstem gliomas are more common in children, but are also seen in adults. However, the use of commercially available COX-2 inhibitors has not been evaluated in the pediatric population and the proper dosing in pediatrics is unknown. Therefore a Phase I study will need to be conducted as a first step. Rofecoxib is an FDA approved COX-2 inhibitor for use in adults. This phase I study is designed to determine the maximum tolerated dose of Rofecoxib given concurrently with standard radiation therapy for diffuse pontine brainstem glioma.

• Glioma
• Brain Neoplasms

Inclusion:

• Newly diagnosed infiltrating lesion involving the pons and an MRI pattern of diffuse infiltration, that is not focal. The tumor may extend beyond the boundary of the pons.
• MRI of the brain with or without gadolinium within 4 weeks of starting therapy.
• Clinical history < 6 months duration
• Children >3 years of age and adults >18 years of age
• Treatment to begin within 6 weeks of diagnosis.
• Written informed consent
• Performance status: ECOG 0,1,2 or equivalent Lansky Play Performance Scale.

• All patients must have adequate bone marrow function (ANC>1000, platelets >100,000, SGPT < 2.5x ULN) and renal function (creatinine clearance >50/ml/min/1.73 m2 or age-adjusted serum creatinine < 3x ULN)

  • MRI of the spine within 4 weeks of starting therapy.

Exclusion:

• Pregnancy. All participants who are of child-bearing age must agree to use a method of birth control/pregnancy prevention.
• Bilirubin > 3x ULN.
• History of gastrointestinal bleeding.
• History of GI perforation due to ulcerative disease.
• Patients who have experienced asthma, urticaria, or allergic-type reactions after taking aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs)
• Prior therapy (Dexamethasone is not considered therapy.)

• Prior malignancy

  • Metastasis to the spine.