OPTIC PATHWAY HYPOTHALAMIC GLIOMAS - A DILEMMA IN MANAGEMENT

Optic pathway gliomas follow an unpredictable course. Some remain stat ic for years; others increase rapidly in size and often lead to death. This unpredictability, along with the histological similarity of thes e tumors, has resulted in controversy about their management. We have reviewed the results of management of all 62 patients with a diagnosis of optic pathway/hypothalamic glioma treated at The Hospital for Sick Children during the years 1976-1990. Twelve patients received no dire ct treatment, and 3 only a biopsy. Six patients were treated with radi otherapy alone. Eight patients received radiotherapy following a biops y. Seventeen patients were treated by resection alone and 16 had a res ection followed by radiotherapy. Eight patients received chemotherapy in addition to other therapy, and in 5 of them the chemotherapy was gi ven as an initial therapy. Forty-eight patients are well with their vi sual deficits but 7 of them are receiving hormone replacement therapy. Six patients have significant neurologic deficits and 8 have died.