TY - JOUR
T1 - The effect of chemotherapy on optic pathway gliomas and their sub-components
T2 - A volumetric MR analysis study
AU - Shofty, Ben
AU - Mauda-Havakuk, Michal
AU - Weizman, Lior
AU - Constantini, Shlomi
AU - Ben-Bashat, Dafna
AU - Dvir, Rina
AU - Pratt, Li Tal
AU - Joskowicz, Leo
AU - Kesler, Anat
AU - Yalon, Michal
AU - Ravid, Lior
AU - Ben-Sira, Liat
N1 - Publisher Copyright:
© 2015 Wiley Periodicals, Inc.
PY - 2015/8/1
Y1 - 2015/8/1
N2 - 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.
AB - 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.
KW - Chemotherapy
KW - Neurofibromatosis I (NF1)
KW - Optic pathway gliomas (OPG)
KW - Pediatric
UR - http://www.scopus.com/inward/record.url?scp=84932199025&partnerID=8YFLogxK
U2 - 10.1002/pbc.25480
DO - 10.1002/pbc.25480
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C2 - 25858021
AN - SCOPUS:84932199025
SN - 1545-5009
VL - 62
SP - 1353
EP - 1359
JO - Pediatric Blood and Cancer
JF - Pediatric Blood and Cancer
IS - 8
ER -