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

Ben Shofty*, Michal Mauda-Havakuk, Lior Weizman, Shlomi Constantini, Dafna Ben-Bashat, Rina Dvir, Li Tal Pratt, Leo Joskowicz, Anat Kesler, Michal Yalon, Lior Ravid, Liat Ben-Sira

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

24 Scopus citations

Abstract

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.

Original languageAmerican English
Pages (from-to)1353-1359
Number of pages7
JournalPediatric Blood and Cancer
Volume62
Issue number8
DOIs
StatePublished - 1 Aug 2015
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2015 Wiley Periodicals, Inc.

Keywords

  • Chemotherapy
  • Neurofibromatosis I (NF1)
  • Optic pathway gliomas (OPG)
  • Pediatric

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