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Challenges in treating children with optic pathway gliomas: an 18-year experience from a middle-income country.
Ramírez-Melo, Jorge Luis; Moreira, Daniel C; Orozco-Alvarado, Ana Luisa; Sánchez-Zubieta, Fernando; Navarro-Martín Del Campo, Regina M.
Afiliação
  • Ramírez-Melo JL; Pediatric Oncology and Hematology Service, Hospital Civil de Guadalajara Dr. Juan I. Menchaca, Guadalajara, Mexico.
  • Moreira DC; Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, United States.
  • Orozco-Alvarado AL; Pediatric Oncology and Hematology Service, Hospital Civil de Guadalajara Dr. Juan I. Menchaca, Guadalajara, Mexico.
  • Sánchez-Zubieta F; Pediatric Oncology and Hematology Service, Hospital Civil de Guadalajara Dr. Juan I. Menchaca, Guadalajara, Mexico.
  • Navarro-Martín Del Campo RM; Pediatric Oncology and Hematology Service, Hospital Civil de Guadalajara Dr. Juan I. Menchaca, Guadalajara, Mexico.
Front Oncol ; 14: 1329729, 2024.
Article em En | MEDLINE | ID: mdl-38414749
ABSTRACT

Introduction:

Patients with optic pathway gliomas (OPG) have good survival rates although their long-term quality of life can be affected by the tumor or treatment-related morbidity. This retrospective study sought to describe the clinical presentation and outcomes of children with OPG at a tertiary center in Mexico.

Methods:

Consecutive patients <18 years-of-age with newly diagnosed OPG between January 2002 and December 2020 at the Hospital Civil de Guadalajara Dr. Juan I. Menchaca in Guadalajara, Mexico were included.

Results:

Thirty patients were identified with a median age of six years. The most frequent clinical manifestations were loss of visual acuity (40%) and headaches (23%). Neurofibromatosis-1 was found in 23.3% of the patients. Surgery, either biopsy or resection, was done in 20 of 30 patients. Two patients died shortly after initial surgery. The 5-year event-free survival (EFS) was 79.3% ± 10.8% and the 5-year overall survival was 89.5% ± 6.9%. Lower EFS was associated with age less than 3 years, intracranial hypertension at presentation, and diencephalic syndrome. Patients who received surgery as first-line treatment had a 3.1 times greater risk of achieving a performance score of less than 90 points at 6 months after diagnosis (p=0.006). Of 10 patients with vision testing, 5 had improvement in visual acuity, 4 had no changes, and one patient showed worsening.

Conclusion:

Our data suggests that favorable outcomes can be achieved with OPG in low- and middle-income countries, although a high rate of surgical complications was described leading to a lower overall survival. These data can be used prospectively to optimize treatment at this institute and other middle-income countries through a comprehensive, multidisciplinary approach.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Front Oncol Ano de publicação: 2024 Tipo de documento: Article País de afiliação: México País de publicação: Suíça

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Front Oncol Ano de publicação: 2024 Tipo de documento: Article País de afiliação: México País de publicação: Suíça