Treatment and Outcome in 65 Children with Optic Pathway Gliomas
| Autor: | Hala Taha, Mohamed A. El Beltagy, Wael Zekri, Nada El-Khateeb, Madeha Awad, Mohamed Reda, Abdelrhman Enayet, Mohamed S. Zaghloul |
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| Rok vydání: | 2015 |
| Předmět: |
Male
Optic Nerve Glioma medicine.medical_specialty Antineoplastic Agents Neurosurgical Procedures 03 medical and health sciences 0302 clinical medicine Biopsy Medicine Humans Fibrillary astrocytoma Neurofibromatosis Retrospective Studies Neurofibromatosis type I medicine.diagnostic_test business.industry Brain Disease Management medicine.disease Debulking Magnetic Resonance Imaging Survival Analysis Surgery Treatment Outcome 030220 oncology & carcinogenesis Child Preschool Optic nerve Histopathology Female Neurology (clinical) Optic nerve glioma business 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | World neurosurgery. 89 |
| ISSN: | 1878-8769 |
| Popis: | Introduction Optic pathway gliomas (OPGs) are rare neoplasms in children with an unpredictable clinical course. There is significant controversy regarding the optimal management and outcome of these patients. Methods Charts of all patients with OPG diagnosed and treated at Children's Cancer Hospital Egypt between July 2007 and July 2014 were retrospectively reviewed. We evaluated the roles of surgical, ophthalmologic, endocrinologic, neurologic, and treatment aspects of care. Results Sixty-five patients were included in this study, with a mean age of 5.3 years. OPGs were chiasmatic ( n = 25), optic nerve ( n = 18), hypothalamic ( n = 7), and chiasmatic/hypothalamic ( n = 7). Extensive involvement of the optic pathway was seen in an additional 8 patients. Twenty cases had neurofibromatosis type 1. Four cases underwent surgical debulking, and 28 were biopsied (16 open, 11 stereotactic, and 1 endoscopic). Nine of the 18 optic nerve tumors were managed by total excision. Twenty-four patients did not undergo any surgical intervention. Forty-five patients received chemotherapy. Histopathology revealed pilocytic ( n = 20), pilomyxoid ( n = 15), fibrillary astrocytoma ( n = 4), and grade I papillary-glioneuronal tumor ( n = 1). Nonrepresentative sample ( n = 1). The 4-year overall survival rate was 86.3% with mean follow-up period of 32.2 months. Conclusion The initial role of surgery in newly developed OPG is biopsy for tissue diagnosis and relief of the hydrocephalus, if present, followed by chemotherapy. Chemotherapy decreases or stabilizes the tumor size in most cases, leading to preservation of both visual and endocrinal functions. The most significant prognostic factor confirmed in this study was the age of the patient. |
| Databáze: | OpenAIRE |
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