Management of optic pathway and chiasmatic-hypothalamic gliomas in children with radiation therapy.
OBJECTIVE
Optic pathway and chiasmatic-hypothalamic gliomas are rare childhood tumors. This study presents the experience in management of these tumors with radiation therapy.


METHODS
Thirty-three children with the diagnosis of optic pathway and chiasmatic-hypothalamic gliomas were treated with radiation therapy from 1973 through 1994 in the Department of Radiation Oncology at Ankara University Faculty of Medicine. Twenty-four children had optic pathway gliomas and nine had chiasmatic-hypothalamic gliomas. Evidence of neurofibromatosis was present in six children. Subtotal resection was performed in 22 children and a biopsy in seven. The most common prescription for total tumor dose was 50 Gy, delivered in 2 Gy daily fractions. Follow-up ranged from 0.5 to 16.1 years (mean, 13.6 years).


RESULTS
Overall, progression-free and cause-specific survival probabilities for the entire group were 93%, 82% and 93%, respectively, at 5 years and 79%, 77% and 88%, respectively, at 10 years. Differences in overall, progression-free and cause-specific survival probabilities between optic pathway and chiasmatic-hypothalamic gliomas were not statistically significant. Absence of evidence of neurofibromatosis correlated with significantly better progression-free and cause-specific survival probabilities.


CONCLUSIONS
Radiation therapy is effective in stabilization or improvement of vision and prevention of tumor progression in both optic pathway and chiasmatic-hypothalamic gliomas.
Erkal
H S
HS
Department of Radiation Oncology, Ankara University Faculty of Medicine, Turkey.
Serin
M
M
Cakmak
A
A
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003390:Cranial Nerve Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005910:Glioma / Q000175:diagnosis / Q000401:mortality / Q000532:radiotherapy*; D006801:Humans; D007029:Hypothalamic Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000532:radiotherapy*; D008297:Male; D017253:Neurofibromatoses / Q000175:diagnosis / Q000532:radiotherapy; D009897:Optic Chiasm; D019574:Optic Nerve Neoplasms / Q000401:mortality / Q000532:radiotherapy; D011379:Prognosis; D011829:Radiation Dosage; D015996:Survival Rate