Visual Acuity of Children Treated With Chemotherapy for Optic Pathway Gliomas
Visual Acuity of Children Treated With Chemotherapy for Optic Pathway Gliomas
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DOI：
10.1002/pbc.24726
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发表时间：
2014-02-01
影响因子：
3.2
通讯作者：
Ospina, Luis H.
中科院分区：
文献类型：
--
作者：
Kalin-Hajdu, Evan;Decarie, Jean-Claude;Ospina, Luis H.
背景化疗是儿童视神经胶质瘤（OPG）最常见的主要治疗方式。由于存在严重视力障碍的风险，视力 (VA) 已成为 OPG 儿童至关重要的临床参数。尽管存在这一现实，大多数研究都忽略了分析化疗对脑胶质瘤患者 VA 影响所需的关键信息。本研究的主要目标是确定首先接受 OPG 化疗的儿童的近期和长期视力结果。程序对最初接受化疗的 OPG 儿童进行回顾性、非比较性病例系列。在化疗前、化疗后以及最后一次随访时测量 VA。结果 7 名儿童（14 只眼）1 型神经纤维瘤病 (NF1) 突变呈阳性，10 名儿童（20 只眼）没有 NF1 突变（散发）。零星人群中有 3 人因 OPG 死亡。幸存者的中位随访时间为 10.544.36 (SD) 年。随着时间的推移，NF1 突变阳性组和散发组的 VA 均出现恶化；然而，仅零星人口的恶化情况具有统计显着性。化疗前、化疗后和最后一次随访时视力低于 20/200 的眼睛比例分别从 18% 增长到 24% 到 38%。 结论 在 NF1 突变型和散发性 OPG 中，化疗后和长期随访中 VA 均恶化。尽管进行了化疗，但随着时间的推移，患有严重功能障碍的眼睛逐渐增多。儿科血癌 2014 年；61：223-227。 (c) 2013 年 Wiley 期刊公司。
BackgroundChemotherapy is the most common primary treatment modality for pediatric optic pathway gliomas (OPGs). Due to the risk of severe visual impairment, visual acuity (VA) has become a clinical parameter of fundamental importance for children with OPGs. Despite this reality, most studies omit crucial information necessary for analysis of the effect of chemotherapy on VA in patients with cerebral gliomas. The principal goal of this study was to determine the immediate and long-term visual outcome of children treated first with chemotherapy for OPGs.ProcedureRetrospective, non-comparative, case series of children with OPGs treated initially with chemotherapy. VA was measured prior to chemotherapy, directly following chemotherapy, as well as at last follow-up.ResultsSeven children (14 eyes) were positive for the neurofibromatosis type-1 (NF1) mutation and 10 children (20 eyes) were without the NF1 mutation (sporadic). Three deaths, all in the sporadic cohort, occurred as a result of their OPG. Median follow-up time of survivors was 10.544.36 (SD) years. Both NF1 mutation positive and sporadic cohorts had deterioration in VA over time; however, deterioration was only statistically significant in the sporadic population. The percentage of eyes with vision weaker than 20/200 prior to chemotherapy, directly following chemotherapy and at last follow-up grew from 18% to 24% to 38%, respectively.ConclusionsIn both NF1 mutant and sporadic OPGs, VA deteriorated directly following chemotherapy as well as at long-term follow-up. Despite chemotherapy, eyes with severe functional impairment gradually increased over time. Pediatr Blood Cancer 2014;61:223-227. (c) 2013 Wiley Periodicals, Inc.