Sahaja Acharya1, Sophia Quesada2, Kenneth Coca2, Cody Richardson3, Mary E Hoehn3, Jason Chiang4, Ibrahim Qaddoumi5, Frederick A Boop6, Amar Gajjar5, Thomas E Merchant2. 1. Department of Radiation Oncology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105, USA. sahaja.acharya@stjude.org. 2. Department of Radiation Oncology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105, USA. 3. Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, TN, USA. 4. Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN, USA. 5. Division of Neuro-Oncology, Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA. 6. Division of Pediatric Neurosurgery, Department of Surgery, St. Jude Children's Research Hospital, Memphis, TN, USA.
Abstract
PURPOSE: Children with sporadic optic pathway glioma (OPG) commonly experience a decline in visual acuity (VA). This study aimed to quantify long-term VA outcomes after definitive radiation therapy (RT). METHODS: From 1997 to 2017, 41 patients underwent RT for OPG and had baseline VA testing. All patients underwent serial VA testing every 3-6 months during the first 5 years and annually thereafter. The cumulative incidence of VA decline or improvement (per eye) was estimated using death as a competing risk. RESULTS: Mean follow-up was 5 years. Most tumors (93%) involved the postchiasmatic optic tracts and/or hypothalamus. Of the tumors tested for BRAF alterations (n = 15), 67% had a BRAF fusion. Median time to VA decline was 20 months in the eye with worse vision and 22 months in the better eye. For the worse eye, the 5-year cumulative incidences of VA decline and improvement were 17.9% [95% confidence interval (CI) 7-32.8%] and 13.5% (95% CI 4.7-26.7%), respectively. For the better eye, the 5-year cumulative incidences of VA decline and improvement were 11.5% (95% CI 3.5-30.7%) and 10.6% (95% CI 2.6-25.2%), respectively. Visual outcomes did not correlate with radiographic evidence of tumor progression. CONCLUSIONS: The 5-year cumulative incidence of VA decline was low. VA decline is most likely to occur within the first 2 years after RT and is not associated with radiographic progression of disease, highlighting the need for frequent ophthalmologic exams during this period.
PURPOSE:Children with sporadic optic pathway glioma (OPG) commonly experience a decline in visual acuity (VA). This study aimed to quantify long-term VA outcomes after definitive radiation therapy (RT). METHODS: From 1997 to 2017, 41 patients underwent RT for OPG and had baseline VA testing. All patients underwent serial VA testing every 3-6 months during the first 5 years and annually thereafter. The cumulative incidence of VA decline or improvement (per eye) was estimated using death as a competing risk. RESULTS: Mean follow-up was 5 years. Most tumors (93%) involved the postchiasmatic optic tracts and/or hypothalamus. Of the tumors tested for BRAF alterations (n = 15), 67% had a BRAF fusion. Median time to VA decline was 20 months in the eye with worse vision and 22 months in the better eye. For the worse eye, the 5-year cumulative incidences of VA decline and improvement were 17.9% [95% confidence interval (CI) 7-32.8%] and 13.5% (95% CI 4.7-26.7%), respectively. For the better eye, the 5-year cumulative incidences of VA decline and improvement were 11.5% (95% CI 3.5-30.7%) and 10.6% (95% CI 2.6-25.2%), respectively. Visual outcomes did not correlate with radiographic evidence of tumor progression. CONCLUSIONS: The 5-year cumulative incidence of VA decline was low. VA decline is most likely to occur within the first 2 years after RT and is not associated with radiographic progression of disease, highlighting the need for frequent ophthalmologic exams during this period.
Authors: G G Grabenbauer; U Schuchardt; M Buchfelder; C M Rödel; G Gusek; M Marx; H G Doerr; R Fahlbusch; W J Huk; D Wenzel; R Sauer Journal: Radiother Oncol Date: 2000-03 Impact factor: 6.280
Authors: E A Eisenhauer; P Therasse; J Bogaerts; L H Schwartz; D Sargent; R Ford; J Dancey; S Arbuck; S Gwyther; M Mooney; L Rubinstein; L Shankar; L Dodd; R Kaplan; D Lacombe; J Verweij Journal: Eur J Cancer Date: 2009-01 Impact factor: 9.162
Authors: Thomas E Merchant; Heather M Conklin; Shengjie Wu; Robert H Lustig; Xiaoping Xiong Journal: J Clin Oncol Date: 2009-07-06 Impact factor: 44.544
Authors: Sahaja Acharya; Jo-Fen Liu; Ruth G Tatevossian; Jason Chiang; Ibrahim Qaddoumi; Amar Gajjar; David Walker; Julie H Harreld; Thomas E Merchant; David W Ellison Journal: Neuro Oncol Date: 2020-08-17 Impact factor: 12.300