SURP-05. LONG-TERM RESULTS OF NOVALIS RADIOSURGICAL TREATMENT IN PATIENTS WITH PEDIATRIC OPTIC PATHWAY/HYPOTHALAMIC GLIOMA

Abstract Pediatric optic pathway/hypothalamic gliomas (OP/HG) are classified by anatomic location as optic nerve, optic chiasm, optic tract and hypothalamus. Treatment of OP/HGs are diverse, surgery, radiation therapy, chemotherapy, and targeted immunotherapy. The objective of this study is long-term results of Novalis radiosurgical treatment of pediatric OP/HGs as a primary treatment option in a single center. We report six cases of an long-term followup results (over 15 years) of Novalis radiosurgical treatment of pediatric OP/HGs for 5 years since February 2001 to May 2006. Radiosurgery was the only treatment after the diagnosis for all patient. However One patient has symptoms of hydrocephalus existed, ventriculoperitoneal shunt was performed. MRI was performed every 3 month during first 6 months, 6 month during next one year, and every year for 4 years. After 5 years, we performed MRI for 2~3 year until 10 years. The mean age of 6 patients was 9.3 (3~13) years. Surgery for partial resection was done in 4 patients, and biopsy in one patient. One patient was diagnosed with MR in optic nerve only lesion. One patient underwent ventriculoperitoneal shunt due to slowly progression of gait disturbance, urinary incontinence. All patients did hyperfraction (25~30) Novalis radiosurgery with low dose (1.5~1.7 Gy). Outcome was successful with no tumor in 3 patients, decrease and stable in 2, and one patient had decrease but radiation change. Vision was improved in one patient, stable in 4 and only one patient became blind after the treatment from finger count vision on right eye initially, but normal vision on left. We treated with hyperfraction radiosurgery only and excellent outcome in small group. So hyperfraction radiosurgery would be a good treatment option in pediatric OP/HGs.