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Visual improvement despite radiologically stable disease after treatment with carboplatin in children with
A E Mitchell1, J E Elder, D A Mackey
1Department of Hematology and Oncology, Royal Children's Hospital, Parkville, Victoria, Australia.
Insights
Carboplatin treatment for pediatric optic/thalamic gliomas showed promising clinical responses, with vision improvement in many cases, even when radiologic assessments indicated stable disease. Further studies are warranted.
Area of Science:
- Pediatric Oncology
- Neuro-oncology
- Ophthalmology
Background:
- Optic and thalamic gliomas are rare pediatric brain tumors.
- Progressive gliomas can lead to significant visual impairment.
- Carboplatin is a chemotherapy agent used in pediatric cancer treatment.
Purpose of the Study:
- To evaluate the clinical and radiological outcomes of carboplatin therapy in children with progressive optic/thalamic gliomas.
- To assess the correlation between radiological tumor response and visual function.
- To determine the efficacy of carboplatin in managing these challenging pediatric brain tumors.
Main Methods:
- A cohort of 12 children with progressive optic/thalamic gliomas received monthly carboplatin chemotherapy between 1997 and 1999.
- Treatment involved a minimum of 12 cycles of carboplatin.
- Patients underwent regular clinical and radiological assessments, including visual function evaluations.
Main Results:
- Nine children achieved stable radiological disease, and one showed a partial radiological response.
- Two children experienced disease progression.
- Vision improved in four children, including those with stable radiological disease and partial response, suggesting a dissociation between radiological and clinical outcomes.
Conclusions:
- Clinical response, particularly visual improvement, may exceed expectations based solely on radiological assessments in children treated with carboplatin for optic/thalamic gliomas.
- Carboplatin demonstrates potential efficacy in managing progressive optic/thalamic gliomas with visual impairment.
- A prospective clinical trial is recommended to further investigate the role of carboplatin in this patient population.
Background:
The purpose of this study was to examine the clinical and radiologic response to carboplatin by children with progressive optic/thalamic gliomas.
Patients And Methods:
Between July 1997 and July 1999, 12 consecutive children were treated with monthly carboplatin for progressive optic/thalamic gliomas.
Results:
Five children have completed 12 cycles of carboplatin and five children are currently receiving treatment. Two children had progressive disease noted both clinically and radiologically. Nine children have stable radiologic disease and one child has had a partial radiologic response to chemotherapy. Eight children have had regular visual assessments. Four children (three with stable radiology and one with a partial radiologic response) have had improvement in their vision. Three children with radiologically stable disease have had no change in vision. One child has had deterioration in vision despite radiologically stable disease.
Conclusions:
The results suggest that the clinical response of optic/thalamic gliomas to carboplatin, as measured by visual acuity and visual fields, may be better than predicted by radiologic assessment. These data suggest that a prospective clinical study is warranted of the role of carboplatin in children with progressive optic/thalamic gliomas and visual impairment.
