Analysis on Therapy and Prognosis of Optic Pathway Gliomas

WU Yun; ZHANG Zi-yin; TANG Jian-jian; LUO An-zhi; ZHANG Zong-yin; WANG Zhi-yun

doi:10.3969/j.issn.1002-3429.2014.08.032

Abstract：Objective To explore the treatment and prognosis of optic pathway gliomas ( OPG) . Methods 56 pa-tients with OPG in our hospital were treated by microsurgical treatment, and 13 patients received appropriate postoperative ra-diation therapy with general total dose of 45-60 Gy. All patients were followed up for 9 months to evaluate visual field and a-cuity and systemic therapeutic effect, and analyze the possible relationship between the postoperative prognosis and the clinico-pathological factors of OPG. Results Pathological examination showed that there were 40 patients with pilocytic astrocytoma, 13 with astrocytoma and 3 with pleomorphic neuroblastoma. The 9-month follow-up results after operation showed 91. 1% of patients with improvement of vision, 94. 6% with recovery of defect of field vision, and headache in forehead and temple dis-appeared. Out of 35 cases of hypothalamus injury, 94. 3% showed marked progress. The tumor recurrence rate was 5. 3%during 12 months of follow-up. The chi-square test showed that:the recurrence rate of the OPG was significantly lower in pa-tients under the age of 14 than that in patients elder than 14-year-old group, and the differences of recovery of visual acuity and improvement of visual field defect were significant between the two groups (P<0. 05); the same phenomenon could be observed in histo-pathological examination which recurrence rate of pleomorphic neuroblastoma was significantly higher than that of other two kinds of pilocytic glioma, and the differences of recovery of visual acuity and improvement of visual field de-fect were also significant (P<0. 05). Conclusion Microsurgical resection combined with postoperative radiotherapy in treat-ment of OPG can improve patient's prognosis significantly, but the effect is not obvious in pleomorphic neuroblastoma.