Long-term outcome of hypothalamic/chiasmatic astrocytomas in children treated with conservative surgery.

摘要: The feasibility of radical surgery for astrocytomas the optic chiasm/hypothalamus has been reported by several groups. Such carries significant risks, however, including permanent damage to pituitary gland, apparatus, hypothalamic structures, and carotid arteries. benefits surgery, both in terms efficacy toxicity, should, therefore, be evaluated against standard therapy, as is usually done new chemotherapeutic protocols. To this end, a retrospective review was performed 33 patients treated at Children's Hospital Philadelphia between 1976 1991 who met criteria that would have made them eligible many centers today, but were with either no or conservative (< 50% resection) biopsy followed adjuvant therapy local radiation (29 patients) and/or chemotherapy actinomycin-D vincristine (18 patients). encompassed all children globular enhancing mass least 2 cm hypothalamic/chiasmatic region, evidence nerve involvement radiations computerized tomography magnetic resonance imaging, follow up 3 years. All one patient had tissue confirmation low-grade pilocytic astrocytoma. Thirteen years age younger diagnosis. Five individuals died: three tumor progression, acute shunt malfunction, intercurrent infection. remaining 28 alive last up, mean 10.9 from Twenty-three surviving functional vision eye, 12 require endocrine replacement, 16 are completed schooling regular academic requirements. If become care long-term survival outcome will equal surpass those historical controls conservatively.