Controversy in the management of optic nerve glioma

Journal Article · Sun Mar 01 04:00:00 EST 1987 · Cancer (Philadelphia); (United States)

DOI:https://doi.org/10.1002/1097-0142(19870301)59:5<1000::AID-CNCR2820590525>3.0.CO;2-N· OSTI ID:6591795

Weiss, L; Sagerman, R H; King, G A; Chung, C T; Dubowy, R L

The records of 16 patients with optic nerve glioma treated between 1961 and 1984 were reviewed. All patients except two had extension of tumor beyond the chiasm to the hypothalamus, adjacent brain and/or along the posterior optic tract. Eleven of 16 cases were biopsy-proven, two patients had craniotomy and visual inspection but no biopsy was performed, and in two cases the biopsy was not diagnostic. Fourteen patients received radiation therapy, usually consisting of 50 Gy in 5 weeks (range 40-56 Gy), one patient was treated surgically and one with chemotherapy. With a follow-up of 1 to 20 years, 7 of the 14 patients irradiated are alive, three patients are dead of disease at 3, 6 and 9 years post-treatment, three were lost to follow-up at 1, 8, and 8 years, and one is dead of intercurrent disease at 5.5 years. Overall vision was improved in five patients and stable in seven following treatment. In two patients, vision could not be evaluated because of young age at presentation. Four patients had recurrences. One was retreated with 30 Gy in 3 weeks and shows no evidence of disease at 20 years. The three other patients died of their disease. There is controversy over the best treatment for these patients. Based on these results and a review of the literature, the authors recommendation is to irradiate tumors with extension beyond the chiasm at the time of presentation rather than waiting for increasing symptoms because function that is lost may not always be recovered. Chemotherapy needs to be further investigated but holds promise, especially for the younger children.

• Research Organization: SUNY Health Science Center, Syracuse
• OSTI ID: 6591795
• Journal Information: Cancer (Philadelphia); (United States), Journal Name: Cancer (Philadelphia); (United States) Vol. 5; ISSN CANCA
• Country of Publication: United States
• Language: English

Related Subjects

550600 -- Medicine
550603* -- Medicine-- External Radiation in Therapy-- (1980-)
62 RADIOLOGY AND NUCLEAR MEDICINE
BODY
BODY AREAS
BRAIN
CENTRAL NERVOUS SYSTEM
CHEMOTHERAPY
COMBINED THERAPY
DISEASES
EYES
FACE
GLIOMAS
HEAD
MEDICINE
NEOPLASMS
NERVES
NERVOUS SYSTEM
NUCLEAR MEDICINE
ORGANS
PATIENTS
RADIOLOGY
RADIOTHERAPY
RECOMMENDATIONS
RETINA
SENSE ORGANS
SURGERY
THERAPY