265 Radiation therapy in optic gliomas of childhood: Prognosis and long term sequela

Abstract

Thirty-three children with the diagnosis of optic glioma were admitted to Department of Radiation Oncology in Ankara University Faculty of Medicine between 1973 and 1994. Twenty-two patients were female and 11 were male, with a female:male ratio of 2:1. Their ages ranged between 1 to 18 (mean:8.4, median:7). Six patients (18.2%) presented with neurofibromatosis. Twenty-nine patients (87.9%) had histopathological diagnosis of astrocytoma. Tumors were confined to the optic nerve in 5 patients (15.1%), confined to the chiasma in 6 patients (18.2%) and involved both the optic nerve and chiasma in 22 patients (66.7%). Subtotal resection of the tumor was perfunned in 20 patients (60.6%). Thirteen patients received irradiation as sole therapy. Two patients were irradiated for recurrent tumors. Mean follow-up was 158 months. Actuarial survival for 5 and 10 years were 91.9% and 77.9% respectively. Age, sex and subtotal resection did not appear to correlate with survival. Presence of neurofibromatosis reminded bad prognosis. One patient developed precocious puberty, two others developed panhypopituitarism and one posterior hypopituitarism. One patient was diagnosed as organic brain syndrome at the age of 30 and two patients had anxiety disorder. Radiotherapy proved to be an effective for tumors involving chiasma where surgery is not feasible. Long tenn follow-up would disclose either treatment or tumor induced sequela.