Skip to main content
NCBI home page
Archives of Disease in Childhood logoLink to Archives of Disease in Childhood
. 1998 Oct;79(4):334–338. doi: 10.1136/adc.79.4.334

Long term follow up of 69 patients treated for optic pathway tumours before the chemotherapy era

C Cappelli 1, J Grill 1, M Raquin 1, A Pierre-Kahn 1, A Lellouch-Tubiana 1, M Terrier-Lacombe 1, J Habrand 1, D Couanet 1, R Brauner 1, D Rodriguez 1, O Hartmann 1, C Kalifa 1
PMCID: PMC1717725  PMID: 9875044

Abstract

AIM—To analyse the long term results of conservative management with radiotherapy in patients with optic pathway tumours.
DESIGN—All 69 patients were symptomatic at diagnosis and most neoplasms involved the optic chiasm and hypothalamus.
RESULTS—At 10 years, overall survival and progression free survival were 83% and 65.5%, respectively. After radiotherapy, vision improved in 18 patients and remained stable in 29 other patients. Cerebrovascular complications occurred in nine of 53 patients treated with radiotherapy after a median interval of two and a half years. These complications were five times more frequent in patients with neurofibromatosis type 1 (NF1). Severe intellectual disabilities were present in 18 children, most of whom underwent irradiation at a very young age (median age, 4years).
IMPLICATIONS—Radiotherapy is a valuable treatment in terms of tumour response, visual outcome, and progression free survival. However, in young children and in patients with NF1, major sequelae are encountered and new treatment strategies should be proposed for these patients.



Full Text

The Full Text of this article is available as a PDF (98.2 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alvord E. C., Jr, Lofton S. Gliomas of the optic nerve or chiasm. Outcome by patients' age, tumor site, and treatment. J Neurosurg. 1988 Jan;68(1):85–98. doi: 10.3171/jns.1988.68.1.0085. [DOI] [PubMed] [Google Scholar]
  2. Bitzer M., Topka H. Progressive cerebral occlusive disease after radiation therapy. Stroke. 1995 Jan;26(1):131–136. doi: 10.1161/01.str.26.1.131. [DOI] [PubMed] [Google Scholar]
  3. Brauner R., Malandry F., Rappaport R., Zucker J. M., Kalifa C., Pierre-Kahn A., Bataini P., Dufier J. L. Growth and endocrine disorders in optic glioma. Eur J Pediatr. 1990 Sep;149(12):825–828. doi: 10.1007/BF02072067. [DOI] [PubMed] [Google Scholar]
  4. Bruggers C. S., Friedman H. S., Phillips P. C., Wiener M. D., Hockenberger B., Oakes W. J., Buckley E. G. Leptomeningeal dissemination of optic pathway gliomas in three children. Am J Ophthalmol. 1991 Jun 15;111(6):719–723. doi: 10.1016/s0002-9394(14)76778-9. [DOI] [PubMed] [Google Scholar]
  5. DODGE H. W., Jr, LOVE J. G., CRAIG W. M., DOCKERTY M. B., KEARNS T. P., HOLMAN C. B., HAYLES A. B. Gliomas of the optic nerves. AMA Arch Neurol Psychiatry. 1958 Jun;79(6):607–621. doi: 10.1001/archneurpsyc.1958.02340060003001. [DOI] [PubMed] [Google Scholar]
  6. Deliganis A. V., Geyer J. R., Berger M. S. Prognostic significance of type 1 neurofibromatosis (von Recklinghausen Disease) in childhood optic glioma. Neurosurgery. 1996 Jun;38(6):1114–1119. doi: 10.1097/00006123-199606000-00010. [DOI] [PubMed] [Google Scholar]
  7. Fletcher W. A., Imes R. K., Hoyt W. F. Chiasmal gliomas: appearance and long-term changes demonstrated by computerized tomography. J Neurosurg. 1986 Aug;65(2):154–159. doi: 10.3171/jns.1986.65.2.0154. [DOI] [PubMed] [Google Scholar]
  8. Gajjar A., Bhargava R., Jenkins J. J., Heideman R., Sanford R. A., Langston J. W., Walter A. W., Kuttesch J. F., Muhlbauer M., Kun L. E. Low-grade astrocytoma with neuraxis dissemination at diagnosis. J Neurosurg. 1995 Jul;83(1):67–71. doi: 10.3171/jns.1995.83.1.0067. [DOI] [PubMed] [Google Scholar]
  9. Garvey M., Packer R. J. An integrated approach to the treatment of chiasmatic-hypothalamic gliomas. J Neurooncol. 1996 May-Jun;28(2-3):167–183. doi: 10.1007/BF00250197. [DOI] [PubMed] [Google Scholar]
  10. Gnekow A. K. Recommendations of the Brain Tumor Subcommittee for the reporting of trials. SIOP Brain Tumor Subcommittee. International Society of Pediatric Oncology. Med Pediatr Oncol. 1995 Feb;24(2):104–108. doi: 10.1002/mpo.2950240209. [DOI] [PubMed] [Google Scholar]
  11. Hoffman H. J., Humphreys R. P., Drake J. M., Rutka J. T., Becker L. E., Jenkin D., Greenberg M. Optic pathway/hypothalamic gliomas: a dilemma in management. Pediatr Neurosurg. 1993 Jul-Aug;19(4):186–195. doi: 10.1159/000120729. [DOI] [PubMed] [Google Scholar]
  12. Jenkin D., Angyalfi S., Becker L., Berry M., Buncic R., Chan H., Doherty M., Drake J., Greenberg M., Hendrick B. Optic glioma in children: surveillance, resection, or irradiation? Int J Radiat Oncol Biol Phys. 1993 Jan 15;25(2):215–225. doi: 10.1016/0360-3016(93)90342-s. [DOI] [PubMed] [Google Scholar]
  13. Kestle J. R., Hoffman H. J., Mock A. R. Moyamoya phenomenon after radiation for optic glioma. J Neurosurg. 1993 Jul;79(1):32–35. doi: 10.3171/jns.1993.79.1.0032. [DOI] [PubMed] [Google Scholar]
  14. Kovalic J. J., Grigsby P. W., Shepard M. J., Fineberg B. B., Thomas P. R. Radiation therapy for gliomas of the optic nerve and chiasm. Int J Radiat Oncol Biol Phys. 1990 Apr;18(4):927–932. doi: 10.1016/0360-3016(90)90418-j. [DOI] [PubMed] [Google Scholar]
  15. Listernick R., Charrow J., Greenwald M., Mets M. Natural history of optic pathway tumors in children with neurofibromatosis type 1: a longitudinal study. J Pediatr. 1994 Jul;125(1):63–66. doi: 10.1016/s0022-3476(94)70122-9. [DOI] [PubMed] [Google Scholar]
  16. Packer R. J., Ater J., Allen J., Phillips P., Geyer R., Nicholson H. S., Jakacki R., Kurczynski E., Needle M., Finlay J. Carboplatin and vincristine chemotherapy for children with newly diagnosed progressive low-grade gliomas. J Neurosurg. 1997 May;86(5):747–754. doi: 10.3171/jns.1997.86.5.0747. [DOI] [PubMed] [Google Scholar]
  17. Packer R. J., Savino P. J., Bilaniuk L. T., Zimmerman R. A., Schatz N. J., Rosenstock J. G., Nelson D. S., Jarrett P. D., Bruce D. A., Schut L. Chiasmatic gliomas of childhood. A reappraisal of natural history and effectiveness of cranial irradiation. Childs Brain. 1983;10(6):393–403. [PubMed] [Google Scholar]
  18. Peto R., Pike M. C., Armitage P., Breslow N. E., Cox D. R., Howard S. V., Mantel N., McPherson K., Peto J., Smith P. G. Design and analysis of randomized clinical trials requiring prolonged observation of each patient. I. Introduction and design. Br J Cancer. 1976 Dec;34(6):585–612. doi: 10.1038/bjc.1976.220. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Petronio J., Edwards M. S., Prados M., Freyberger S., Rabbitt J., Silver P., Levin V. A. Management of chiasmal and hypothalamic gliomas of infancy and childhood with chemotherapy. J Neurosurg. 1991 May;74(5):701–708. doi: 10.3171/jns.1991.74.5.0701. [DOI] [PubMed] [Google Scholar]
  20. Pierce S. M., Barnes P. D., Loeffler J. S., McGinn C., Tarbell N. J. Definitive radiation therapy in the management of symptomatic patients with optic glioma. Survival and long-term effects. Cancer. 1990 Jan 1;65(1):45–52. doi: 10.1002/1097-0142(19900101)65:1<45::aid-cncr2820650111>3.0.co;2-z. [DOI] [PubMed] [Google Scholar]
  21. Prados M. D., Edwards M. S., Rabbitt J., Lamborn K., Davis R. L., Levin V. A. Treatment of pediatric low-grade gliomas with a nitrosourea-based multiagent chemotherapy regimen. J Neurooncol. 1997 May;32(3):235–241. doi: 10.1023/a:1005736104205. [DOI] [PubMed] [Google Scholar]
  22. Rosenstock J. G., Packer R. J., Bilaniuk L., Bruce D. A., Radcliffe J. L., Savino P. Chiasmatic optic glioma treated with chemotherapy. A preliminary report. J Neurosurg. 1985 Dec;63(6):862–866. doi: 10.3171/jns.1985.63.6.0862. [DOI] [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Publishing Group

RESOURCES