title: The effect of chemotherapy on optic pathway gliomas and their sub-components: A volumetric MR analysis study.
abstract: BACKGROUND
  Optic pathway gliomas (OPG) represent 5% of pediatric brain tumors and compose a major therapeutic dilemma to the treating physicians. While chemotherapy is widely used for these tumors, our ability to predict radiological response is still lacking. In this study, we use volumetric imaging to examine in detail the long-term effect of chemotherapy on the tumor as well as its various sub-components.
  
  
  METHODS
  The tumors of 15 patients with OPG, treated with chemotherapy, were longitudinally measured using our novel, previously described volumetric method. Patients were treated with up to five lines of chemotherapy. Sufficient follow-up imaging data, and patient's numbers, allowed for analysis of two treatment lines. Volumetric measurements of the tumors were segmented into solid-non-enhancing, solid-enhancing, and cystic components. Outcome analysis was done per specific treatment line and for the overall follow-up period.
  
  
  RESULTS
  An average reduction of 9.7% (±23%) in the gross-total-solid volume (GTSV) was noted following treatment with vincristine and carboplatin. The cystic component grew under therapy by an average of 12.6% (±39%). When measured over the course of the whole study period, the cystic component grew by an average of 35% (±100%) and the GTSV increased by 12% (±35%).
  
  
  CONCLUSIONS
  Initial treatment with vincristine and carboplatin seems to have a minimal initial effect, mostly on the solid components. The cystic component in itself seems to be unaffected by chemotherapy, and contributes to the subsequent growth of the total volume. During the overall treatment period, both solid and cystic components grew regardless of combined treatment methods.
authors: The Gilbert Israeli Neurofibromatosis Center.|Pediatric Neurosurgery Dana Children's Hospital.
authors: Ben
authors: B
authors: Shofty
authors: The Gilbert Israeli Neurofibromatosis Center.|Pediatric Radiology Unit.
authors: Michal
authors: M
authors: Mauda-Havakuk
authors: Functional Brain Center, The Wohl Institute for Advanced Imaging.
authors: Lior
authors: L
authors: Weizman
authors: The Gilbert Israeli Neurofibromatosis Center.|Pediatric Neurosurgery Dana Children's Hospital.
authors: Shlomi
authors: S
authors: Constantini
authors: Pediatric Hematology-Oncology, all at the Tel-Aviv Medical Center and The Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors: Dafna
authors: D
authors: Ben-Bashat
authors: School of Engineering and Computer Science, The Hebrew University of Jerusalem, Jerusalem, Israel.
authors: Rina
authors: R
authors: Dvir
authors: The Gilbert Israeli Neurofibromatosis Center.|Pediatric Radiology Unit.
authors: Li-Tal
authors: LT
authors: Pratt
authors: Functional Brain Center, The Wohl Institute for Advanced Imaging.
authors: Leo
authors: L
authors: Joskowicz
authors: The Gilbert Israeli Neurofibromatosis Center.
authors: Anat
authors: A
authors: Kesler
authors: Pediatric Hematology Oncology, Sheba Medical Center, Tel-Hashomer, Israel.
authors: Michal
authors: M
authors: Yalon
authors: The Gilbert Israeli Neurofibromatosis Center.
authors: Lior
authors: L
authors: Ravid
authors: The Gilbert Israeli Neurofibromatosis Center.|Pediatric Radiology Unit.
authors: Liat
authors: L
authors: Ben-Sira
mesh_terms: D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016190:Carboplatin / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005134:Eye Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D017253:Neurofibromatoses / Q000000981:diagnostic imaging / Q000188:drug therapy*; D020339:Optic Nerve Glioma / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011859:Radiography; D012189:Retrospective Studies; D047368:Tumor Burden / Q000187:drug effects*; D014747:Vinblastine / Q000627:therapeutic use; D014750:Vincristine / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D014750:Vincristine; D014747:Vinblastine; D016190:Carboplatin
keywords: chemotherapy; neurofibromatosis I (NF1); optic pathway gliomas (OPG); pediatric