title: Visual outcomes in pediatric optic pathway glioma after conformal radiation therapy.
abstract: OBJECTIVE
  To assess visual outcome prospectively after conformal radiation therapy (CRT) in children with optic pathway glioma.
  
  
  METHODS
  We used CRT to treat optic pathway glioma in 20 children (median age 9.3 years) between July 1997 and January 2002. We assessed changes in visual acuity using the logarithm of the minimal angle of resolution after CRT (54 Gy) with a median follow-up of 24 months. We included in the study children who underwent chemotherapy (8 patients) or resection (9 patients) before CRT.
  
  
  RESULTS
  Surgery played a major role in determining baseline (pre-CRT) visual acuity (better eye: P=.0431; worse eye: P=.0032). The visual acuity in the worse eye was diminished at baseline (borderline significant) with administration of chemotherapy before CRT (P=.0726) and progression of disease prior to receiving CRT (P=.0220). In the worse eye, improvement in visual acuity was observed in patients who did not receive chemotherapy before CRT (P=.0289).
  
  
  CONCLUSIONS
  Children with optic pathway glioma initially treated with chemotherapy prior to receiving radiation therapy have decreased visual acuity compared with those who receive primary radiation therapy. Limited surgery before radiation therapy may have a role in preserving visual acuity.
authors.affiliation: Division of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
authors.forename: Richard M
authors.initials: RM
authors.lastname: Awdeh
authors.forename: Erin N
authors.initials: EN
authors.lastname: Kiehna
authors.forename: Richard D
authors.initials: RD
authors.lastname: Drewry
authors.forename: Natalie C
authors.initials: NC
authors.lastname: Kerr
authors.forename: Barrett G
authors.initials: BG
authors.lastname: Haik
authors.forename: Shengjie
authors.initials: S
authors.lastname: Wu
authors.forename: Xiaoping
authors.initials: X
authors.lastname: Xiong
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Merchant
mesh_terms: D000293:Adolescent; D000465:Algorithms; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D020339:Optic Nerve Glioma / Q000188:drug therapy / Q000503:physiopathology / Q000532:radiotherapy* / Q000601:surgery; D011879:Radiotherapy Dosage; D020266:Radiotherapy, Conformal / Q000379:methods*; D016896:Treatment Outcome; D047368:Tumor Burden; D014792:Visual Acuity / Q000187:drug effects / Q000502:physiology / Q000528:radiation effects*
chemical_list: D000970:Antineoplastic Agents