Skip to main content
SpringerLink
Log in

Optic Pathway Glioma

  • Chapter
  • First Online:
Radiation Oncology for Pediatric CNS Tumors

  • 1313 Accesses

Abstract

Pediatric optic pathway gliomas share common clinicoradiographic characteristics and are typically World Health Organization grade I/II astrocytomas. Management of these tumors presents a therapeutic challenge based on host age as well as anatomic location. Radical excision is limited to tumors with unilateral optic nerve involvement and irretrievable ipsilateral vision loss. Subtotal resection is reserved for tissue diagnosis and acute symptom relief. Chemotherapy is infrequently curative but may effectively delay radiotherapy, allowing critical neurocognitive and neuroendocrine development in young children. For most lesions, radiotherapy offers the best option of local control but carries a range of risks related to adjacent normal tissue exposure.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Adan L, Trivin C, Sainte-Rose C, Zucker JM, Hartmann O, Brauner R (2001) GH deficiency caused by cranial irradiation during childhood: factors and markers in young adults. J Clin Endocrinol Metab 86(11):5245–5251. doi:10.1210/jcem.86.11.8056

    Article  CAS  PubMed  Google Scholar 

  • Alvord EC Jr, Lofton S (1988) Gliomas of the optic nerve or chiasm. Outcome by patients’ age, tumor site, and treatment. J Neurosurg 68(1):85–98. doi:10.3171/jns.1988.68.1.0085

    Article  PubMed  Google Scholar 

  • Aquino VM, Fort DW, Kamen BA (1999) Carboplatin for the treatment of children with newly diagnosed optic chiasm gliomas: a phase II study. J Neurooncol 41(3):255–259

    Article  CAS  PubMed  Google Scholar 

  • Ater JL, Zhou T, Holmes E, Mazewski CM, Booth TN, Freyer DR, Lazarus KH, Packer RJ, Prados M, Sposto R, Vezina G, Wisoff JH, Pollack IF (2012) Randomized study of two chemotherapy regimens for treatment of low-grade glioma in young children: a report from the Children’s Oncology Group. J Clin Oncol 30(21):2641–2647. doi:10.1200/JCO.2011.36.6054

    Article  PubMed Central  PubMed  Google Scholar 

  • Awdeh RM, Kiehna EN, Drewry RD, Kerr NC, Haik BG, Wu S, Xiong X, Merchant TE (2012) Visual outcomes in pediatric optic pathway glioma after conformal radiation therapy. Int J Radiat Oncol Biol Phys 84(1):46–51. doi:10.1016/j.ijrobp.2011.10.067

    Article  PubMed Central  PubMed  Google Scholar 

  • Bikowska-Opalach B, Jackowska T (2013) Neurofibromatosis type 1—description of clinical features and molecular mechanism of the disease. Med Wieku Rozwoj 17(4):334–340

    PubMed  Google Scholar 

  • Bouffet E, Jakacki R, Goldman S, Hargrave D, Hawkins C, Shroff M, Hukin J, Bartels U, Foreman N, Kellie S, Hilden J, Etzl M, Wilson B, Stephens D, Tabori U, Baruchel S (2012) Phase II study of weekly vinblastine in recurrent or refractory pediatric low-grade glioma. J Clin Oncol 30(12):1358–1363. doi:10.1200/JCO.2011.34.5843

    Article  CAS  PubMed  Google Scholar 

  • Brauner R, Malandry F, Rappaport R, Zucker JM, Kalifa C, Pierre-Kahn A, Bataini P, Dufier JL (1990) Growth and endocrine disorders in optic glioma. Eur J Pediatr 149(12):825–828

    Article  CAS  PubMed  Google Scholar 

  • Brossier NM, Gutmann DH (2015) Improving outcomes for neurofibromatosis 1-associated brain tumors. Expert Rev Anticancer Ther 15(4):415–423. doi:10.1586/14737140.2015.1009043

    Article  CAS  PubMed  Google Scholar 

  • Cappelli C, Grill J, Raquin M, Pierre-Kahn A, Lellouch-Tubiana A, Terrier-Lacombe MJ, Habrand JL, Couanet D, Brauner R, Rodriguez D, Hartmann O, Kalifa C (1998) Long-term follow up of 69 patients treated for optic pathway tumours before the chemotherapy era. Arch Dis Child 79(4):334–338

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Carpentieri SC, Waber DP, Pomeroy SL, Scott RM, Goumnerova LC, Kieran MW, Billett AL, Tarbell NJ (2003) Neuropsychological functioning after surgery in children treated for brain tumor. Neurosurgery 52(6):1348–1356. discussion 1356-1347

    Article  PubMed  Google Scholar 

  • Chong AL, Pole JD, Scheinemann K, Hukin J, Tabori U, Huang A, Bouffet E, Bartels U (2013) Optic pathway gliomas in adolescence—time to challenge treatment choices? Neuro Oncol 15(3):391–400. doi:10.1093/neuonc/nos312

    Article  CAS  PubMed  Google Scholar 

  • Chung CS, Yock TI, Nelson K, Xu Y, Keating NL, Tarbell NJ (2013) Incidence of second malignancies among patients treated with proton versus photon radiation. Int J Radiat Oncol Biol Phys 87(1):46–52. doi:10.1016/j.ijrobp.2013.04.030

    Article  CAS  PubMed  Google Scholar 

  • D’Arco F, D’Amico A, Caranci F, Di Paolo N, Melis D, Brunetti A (2014) Cerebrovascular stenosis in neurofibromatosis type 1 and utility of magnetic resonance angiography: our experience and literature review. Radiol Med 119(6):415–421. doi:10.1007/s11547-013-0358-8

    PubMed  Google Scholar 

  • Dodge HW Jr, Love JG, Craig WM, Dockerty MB, Kearns TP, Holman CB, Hayles AB (1958) Gliomas of the optic nerves. AMA Arch Neurol Psychiatry 79(6):607–621

    Article  PubMed  Google Scholar 

  • Dotson EM, Connat JL, Diehl PA (1991) Cuticle deposition and ecdysteroid titers during embryonic and larval development of the argasid tick Ornithodoros moubata (Murray, 1877, sensu Walton, 1962) (Ixodoidea:Argasidae). Gen Comp Endocrinol 82(3):386–400

    Article  CAS  PubMed  Google Scholar 

  • Dutton JJ (1994) Gliomas of the anterior visual pathway. Surv Ophthalmol 38(5):427–452

    Article  CAS  PubMed  Google Scholar 

  • Erkal HS, Serin M, Cakmak A (1997) Management of optic pathway and chiasmatic-hypothalamic gliomas in children with radiation therapy. Radiother Oncol 45(1):11–15

    Article  CAS  PubMed  Google Scholar 

  • Flickinger JC, Torres C, Deutsch M (1988) Management of low-grade gliomas of the optic nerve and chiasm. Cancer 61(4):635–642

    Article  CAS  PubMed  Google Scholar 

  • Fouladi M, Wallace D, Langston JW, Mulhern R, Rose SR, Gajjar A, Sanford RA, Merchant TE, Jenkins JJ, Kun LE, Heideman RL (2003) Survival and functional outcome of children with hypothalamic/chiasmatic tumors. Cancer 97(4):1084–1092. doi:10.1002/cncr.11119

    Article  PubMed  Google Scholar 

  • Gnekow AK, Falkenstein F, von Hornstein S, Zwiener I, Berkefeld S, Bison B, Warmuth-Metz M, Driever PH, Soerensen N, Kortmann RD, Pietsch T, Faldum A (2012) Long-term follow-up of the multicenter, multidisciplinary treatment study HIT-LGG-1996 for low-grade glioma in children and adolescents of the German Speaking Society of Pediatric Oncology and Hematology. Neuro Oncol 14(10):1265–1284. doi:10.1093/neuonc/nos202

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Goodden J, Pizer B, Pettorini B, Williams D, Blair J, Didi M, Thorp N, Mallucci C (2014) The role of surgery in optic pathway/hypothalamic gliomas in children. J Neurosurg Pediatr 13(1):1–12. doi:10.3171/2013.8.PEDS12546

    Article  PubMed  Google Scholar 

  • Gower DJ, Pollay M, Shuman RM, Brumback RA (1990) Cystic optic glioma. Neurosurgery 26(1):133–136

    Article  CAS  PubMed  Google Scholar 

  • Greenberger BA, Pulsifer MB, Ebb DH, MacDonald SM, Jones RM, Butler WE, Huang MS, Marcus KJ, Oberg JA, Tarbell NJ, Yock TI (2014) Clinical outcomes and late endocrine, neurocognitive, and visual profiles of proton radiation for pediatric low-grade gliomas. Int J Radiat Oncol Biol Phys 89(5):1060–1068. doi:10.1016/j.ijrobp.2014.04.053

    Article  PubMed  Google Scholar 

  • Grill J, Couanet D, Cappelli C, Habrand JL, Rodriguez D, Sainte-Rose C, Kalifa C (1999) Radiation-induced cerebral vasculopathy in children with neurofibromatosis and optic pathway glioma. Ann Neurol 45(3):393–396

    Article  CAS  PubMed  Google Scholar 

  • Halperin EC, Brady LW, Wazer DE, Perez CA (2013) Perez & Brady’s principles and practice of radiation oncology. Lippincott Williams & Wilkins, Philadelphia

    Google Scholar 

  • Horwich A, Bloom HJ (1985) Optic gliomas: radiation therapy and prognosis. Int J Radiat Oncol Biol Phys 11(6):1067–1079

    Article  CAS  PubMed  Google Scholar 

  • Indelicato D, Rotondo R, Flampouri S, Sandler E, Aldana P, Mendenhall N, Marcus R (2012) Pediatric low grade glioma: early outcomes from the UFPTI experience. In: Société Internationale d’Oncologie Pédiatrique (SIOP) 2012 Annual Meeting, London

    Google Scholar 

  • Jahraus CD, Tarbell NJ (2006) Optic pathway gliomas. Pediatr Blood Cancer 46(5):586–596. doi:10.1002/pbc.20655

    Article  PubMed  Google Scholar 

  • Janss AJ, Grundy R, Cnaan A, Savino PJ, Packer RJ, Zackai EH, Goldwein JW, Sutton LN, Radcliffe J, Molloy PT et al (1995) Optic pathway and hypothalamic/chiasmatic gliomas in children younger than age 5 years with a 6-year follow-up. Cancer 75(4):1051–1059

    Article  CAS  PubMed  Google Scholar 

  • Jenkin D, Angyalfi S, Becker L, Berry M, Buncic R, Chan H, Doherty M, Drake J, Greenberg M, Hendrick B et al (1993) Optic glioma in children: surveillance, resection, or irradiation? Int J Radiat Oncol Biol Phys 25(2):215–225

    Article  CAS  PubMed  Google Scholar 

  • Kalin-Hajdu E, Decarie JC, Marzouki M, Carret AS, Ospina LH (2014) Visual acuity of children treated with chemotherapy for optic pathway gliomas. Pediatr Blood Cancer 61(2):223–227. doi:10.1002/pbc.24726

    Article  CAS  PubMed  Google Scholar 

  • Kestle JR, Hoffman HJ, Mock AR (1993) Moyamoya phenomenon after radiation for optic glioma. J Neurosurg 79(1):32–35. doi:10.3171/jns.1993.79.1.0032

    Article  CAS  PubMed  Google Scholar 

  • Kornreich L, Blaser S, Schwarz M, Shuper A, Vishne TH, Cohen IJ, Faingold R, Michovitz S, Koplewitz B, Horev G (2001) Optic pathway glioma: correlation of imaging findings with the presence of neurofibromatosis. AJNR Am J Neuroradiol 22(10):1963–1969

    CAS  PubMed  Google Scholar 

  • Listernick R, Ferner RE, Liu GT, Gutmann DH (2007) Optic pathway gliomas in neurofibromatosis-1: controversies and recommendations. Ann Neurol 61(3):189–198. doi:10.1002/ana.21107

    Article  CAS  PubMed  Google Scholar 

  • Lopez Ibor JJ (1975) Behavioral science before the environmental degrading. An R Acad Nac Med (Madr) 92(2):253–261

    CAS  Google Scholar 

  • McCowage G, Tien R, McLendon R, Felsberg G, Fuchs H, Graham ML, Kurtzberg J, Moghrabi A, Ferrell L, Kerby T, Duncan-Brown M, Stewart E, Robertson PL, Colvin OM, Golembe B, Bigner DD, Friedman HS (1996) Successful treatment of childhood pilocytic astrocytomas metastatic to the leptomeninges with high-dose cyclophosphamide. Med Pediatr Oncol 27(1):32–39. doi:10.1002/(SICI)1096-911X(199607)27:1<32::AID-MPO7>3.0.CO;2-V

    Article  CAS  PubMed  Google Scholar 

  • Medlock MD, Scott RM (1997) Optic chiasm astrocytomas of childhood. 2. Surgical management. Pediatr Neurosurg 27(3):129–136

    Article  CAS  PubMed  Google Scholar 

  • Merchant TE, Hua CH, Shukla H, Ying X, Nill S, Oelfke U (2008) Proton versus photon radiotherapy for common pediatric brain tumors: comparison of models of dose characteristics and their relationship to cognitive function. Pediatr Blood Cancer 51(1):110–117. doi:10.1002/pbc.21530

    Article  PubMed  Google Scholar 

  • Merchant TE, Kun LE, Wu S, Xiong X, Sanford RA, Boop FA (2009) Phase II trial of conformal radiation therapy for pediatric low-grade glioma. J Clin Oncol 27(22):3598–3604. doi:10.1200/JCO.2008.20.9494

    Article  PubMed Central  PubMed  Google Scholar 

  • Moteabbed M, Yock TI, Paganetti H (2014) The risk of radiation-induced second cancers in the high to medium dose region: a comparison between passive and scanned proton therapy, IMRT and VMAT for pediatric patients with brain tumors. Phys Med Biol 59(12):2883–2899. doi:10.1088/0031-9155/59/12/2883

    Article  PubMed  Google Scholar 

  • Padovani L, Andre N, Constine LS, Muracciole X (2012) Neurocognitive function after radiotherapy for paediatric brain tumours. Nat Rev Neurol 8(10):578–588. doi:10.1038/nrneurol.2012.182

    Article  CAS  PubMed  Google Scholar 

  • Perilongo G, Garre ML, Giangaspero F (2003) Low-grade gliomas and leptomeningeal dissemination: a poorly understood phenomenon. Childs Nerv Syst 19(4):197–203. doi:10.1007/s00381-003-0733-1

    PubMed  Google Scholar 

  • Petrak B, Bendova S, Lisy J, Kraus J, Zatrapa T, Glombova M, Zamecnik J (2015) Neurofibromatosis von Recklinghausen type 1 (NF1)—clinical picture and molecular-genetics diagnostic. Cesk Patol 51(1):34–40

    PubMed  Google Scholar 

  • Pons MA, Finlay JL, Walker RW, Puccetti D, Packer RJ, McElwain M (1992) Chemotherapy with vincristine (VCR) and etoposide (VP-16) in children with low-grade astrocytoma. J Neurooncol 14(2):151–158

    Article  CAS  PubMed  Google Scholar 

  • Rodriguez LA, Edwards MS, Levin VA (1990) Management of hypothalamic gliomas in children: an analysis of 33 cases. Neurosurgery 26(2):242–246. discussion 246-247

    Article  CAS  PubMed  Google Scholar 

  • Rodriguez FJ, Ligon AH, Horkayne-Szakaly I, Rushing EJ, Ligon KL, Vena N, Garcia DI, Cameron JD, Eberhart CG (2012) BRAF duplications and MAPK pathway activation are frequent in gliomas of the optic nerve proper. J Neuropathol Exp Neurol 71(9):789–794. doi:10.1097/NEN.0b013e3182656ef8

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Shamji MF, Benoit BG (2007) Syndromic and sporadic pediatric optic pathway gliomas: review of clinical and histopathological differences and treatment implications. Neurosurg Focus 23(5):E3. doi:10.3171/FOC-07/11/E3

    Article  PubMed  Google Scholar 

  • Shofty B, Ben-Sira L, Freedman S, Yalon M, Dvir R, Weintraub M, Toledano H, Constantini S, Kesler A (2011) Visual outcome following chemotherapy for progressive optic pathway gliomas. Pediatr Blood Cancer 57(3):481–485. doi:10.1002/pbc.22967

    Article  PubMed  Google Scholar 

  • Silva MM, Goldman S, Keating G, Marymont MA, Kalapurakal J, Tomita T (2000) Optic pathway hypothalamic gliomas in children under three years of age: the role of chemotherapy. Pediatr Neurosurg 33(3):151–158

    Article  CAS  PubMed  Google Scholar 

  • Sutton LN, Molloy PT, Sernyak H, Goldwein J, Phillips PL, Rorke LB, Moshang T Jr, Lange B, Packer RJ (1995) Long-term outcome of hypothalamic/chiasmatic astrocytomas in children treated with conservative surgery. J Neurosurg 83(4):583–589. doi:10.3171/jns.1995.83.4.0583

    Article  CAS  PubMed  Google Scholar 

  • Tao ML, Barnes PD, Billett AL, Leong T, Shrieve DC, Scott RM, Tarbell NJ (1997) Childhood optic chiasm gliomas: radiographic response following radiotherapy and long-term clinical outcome. Int J Radiat Oncol Biol Phys 39(3):579–587

    Article  CAS  PubMed  Google Scholar 

  • Taveras JM, Mount LA, Wood EH (1956) The value of radiation therapy in the management of glioma of the optic nerves and chiasm. Radiology 66(4):518–528. doi:10.1148/66.4.518

    Article  CAS  PubMed  Google Scholar 

  • Tenny RT, Laws ER Jr, Younge BR, Rush JA (1982) The neurosurgical management of optic glioma. Results in 104 patients. J Neurosurg 57(4):452–458. doi:10.3171/jns.1982.57.4.0452

    Article  CAS  PubMed  Google Scholar 

  • Walker DA, Liu J, Kieran M, Jabado N, Picton S, Packer R, St Rose C (2013) A multi-disciplinary consensus statement concerning surgical approaches to low-grade, high-grade astrocytomas and diffuse intrinsic pontine gliomas in childhood (CPN Paris 2011) using the Delphi method. Neuro Oncol 15(4):462–468. doi:10.1093/neuonc/nos330

    Article  PubMed Central  PubMed  Google Scholar 

  • Wisoff JH, Abbott R, Epstein F (1990) Surgical management of exophytic chiasmatic-hypothalamic tumors of childhood. J Neurosurg 73(5):661–667. doi:10.3171/jns.1990.73.5.0661

    Article  CAS  PubMed  Google Scholar 

  • Wong JY, Uhl V, Wara WM, Sheline GE (1987) Optic gliomas. A reanalysis of the University of California, San Francisco experience. Cancer 60(8):1847–1855

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiation Oncology, University of Florida, 2000 SW Archer Rd, Gainesville, FL, 32610, USA

    Julie A. Bradley M.D., Ronny L. Rotondo M.D., C.M. & Daniel J. Indelicato M.D.

  2. University of Florida Proton Therapy Institute, 2015 North Jefferson St., Jacksonville, FL, 32206, USA

    Daniel J. Indelicato M.D.

Authors
  1. Julie A. Bradley M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ronny L. Rotondo M.D., C.M.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Daniel J. Indelicato M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Daniel J. Indelicato M.D. .

Editor information

Editors and Affiliations

  1. Dept. of Radiation Oncology, Mayo Clinic Dept. of Radiation Oncology, Rochester, Minnesota, USA

    Anita Mahajan

  2. MD Anderson Cancer Center, Houston, Texas, USA

    Arnold Paulino

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Bradley, J.A., Rotondo, R.L., Indelicato, D.J. (2018). Optic Pathway Glioma. In: Mahajan, A., Paulino, A. (eds) Radiation Oncology for Pediatric CNS Tumors. Springer, Cham. https://doi.org/10.1007/978-3-319-55430-3_11

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-55430-3_11

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-55428-0

  • Online ISBN: 978-3-319-55430-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation