title: Visual pathway glioma in children treated with chemotherapy.
abstract: Visual pathway gliomas occur predominantly in young children. Chemotherapy has been increasingly used as a first-line treatment because of the complications caused by radiotherapy and surgery. Nine children between 6 months and 9 years (median age of 4.8 years) were treated with vincristine and carboplatin according to the SIOP (Société Internationale d'Oncologie Pédiatrique) low-grade glioma 1996 protocol. Five patients had evidence of neurofibromatosis type 1. Magnetic resonance imaging (MRI) and ophthalmological assessment were performed during and after treatment. There was a positive response in all children (100%). Three patients developed progressive disease between 8 and 12 months after ceasing treatment. One of them, being only 2.5 years old, was again treated by chemotherapy with partial response on MRI. Patients with neurofibromatosis type 1 never developed progressive disease. Our data suggest that chemotherapy is an effective treatment option in young children with visual pathway gliomas. MRI is an important means of monitoring the tumour response provided that a rigid imaging protocol is used to detect the early tumoral changes.
authors.affiliation: Department of Radiology, University Hospitals, Leuven, Belgium. philippe.demaerel@uz.kuleuven.ac.be
authors.forename: Philippe
authors.initials: P
authors.lastname: Demaerel
authors.forename: Nele
authors.initials: N
authors.lastname: de Ruyter
authors.forename: Ingele
authors.initials: I
authors.lastname: Casteels
authors.forename: Marleen
authors.initials: M
authors.lastname: Renard
authors.forename: Anne
authors.initials: A
authors.lastname: Uyttebroeck
authors.forename: Stefaan
authors.initials: S
authors.lastname: van Gool
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000473:pathology* / Q000503:physiopathology; D016190:Carboplatin / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005910:Glioma / Q000188:drug therapy* / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D014750:Vincristine / Q000627:therapeutic use*; D014792:Visual Acuity / Q000502:physiology; D014794:Visual Fields / Q000502:physiology; D014795:Visual Pathways / Q000473:pathology* / Q000503:physiopathology
chemical_list: D014750:Vincristine; D016190:Carboplatin