The effect of chemotherapy on optic pathway gliomas and their sub-components: A volumetric MR analysis study

• Published in: Pediatric blood & cancer Vol. 62; no. 8; pp. 1353 - 1359
• Main Authors: Shofty, Ben, Mauda-Havakuk, Michal, Weizman, Lior, Constantini, Shlomi, Ben-Bashat, Dafna, Dvir, Rina, Pratt, Li-Tal, Joskowicz, Leo, Kesler, Anat, Yalon, Michal, Ravid, Lior, Ben-Sira, Liat
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.08.2015; Wiley Subscription Services, Inc
• Subjects: Adolescent; Adult; Antineoplastic Agents - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Brain cancer; Brain tumors; Cancer; Carboplatin; Carboplatin - therapeutic use; Chemotherapy; Child; Child, Preschool; Combined treatment; Disease Progression; Eye Neoplasms - diagnostic imaging; Eye Neoplasms - drug therapy; Female; Genetic disorders; Glioma; Hematology; Humans; Infant; Male; Medical personnel; Neurofibromatoses - diagnostic imaging; Neurofibromatoses - drug therapy; neurofibromatosis I (NF1); Neuroimaging; Neurological disorders; Oncology; Optic Nerve Glioma - diagnostic imaging; Optic Nerve Glioma - drug therapy; optic pathway gliomas (OPG); Patients; pediatric; Pediatrics; Radiography; Retrospective Studies; Tumor Burden - drug effects; Tumors; Vinblastine - therapeutic use; Vincristine; Vincristine - therapeutic use; Young Adult; neurofibromatosis I (NF1); optic pathway gliomas (OPG); chemotherapy; pediatric
• ISSN: 1545-5009; 1545-5017
• DOI: 10.1002/pbc.25480

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. Procedure 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%). Conclusion 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. Pediatr Blood Cancer 2015;62:1353–1359. © 2015 Wiley Periodicals, Inc.