MANAGEMENT OF OPTIC PATHWAY AND CHIASMATIC-HYPOTHALAMIC GLIOMAS IN CHILDREN WITH RADIATION-THERAPY

Background and purpose: Optic pathway and chiasmatic-hypothalamic glio mas are rare childhood tumors. This study presents the experience in m anagement of these tumors with radiation therapy. Materials and method s: Thirty-three children with the diagnosis of optic pathway and chias matic-hypothalamic gliomas were treated with radiation therapy from 19 73 through 1994 in the Department of Radiation Oncology at Ankara Univ ersity Faculty of Medicine. Twenty-four children had optic pathway gli omas and nine had chiasmatic-hypothalamic gliomas. Evidence of neurofi bromatosis was present in six children. Subtotal resection was perform ed 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. Fol low-up ranged from 0.5 to 16.1 years (mean, 13.6 years). Results: Over all, progression-free and cause-specific survival probabilities for th e entire group were 93%, 82% and 93%, respectively, at 5 years and 79% , 77% and 88%, respectively, at 10 years. Differences in overall, prog ression-free and cause specific survival probabilities between optic p athway and chiasmatic-hypothalamic gliomas were not statistically sign ificant. Absence of evidence of neurofibromatosis correlated with sign ificantly better progression-free and cause-specific survival probabil ities. Conclusion: Radiation therapy is effective in stabilization or improvement of vision and prevention of tumor progression in both opti c pathway and chiasmatic-hypothalamic gliomas. (C) 1997 Elsevier Scien ce Ireland Ltd.