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Ocular and Orbital Malignancies

  • John T. LucasJr.
  • Jeffrey C. BuchsbaumEmail author
Chapter
Part of the Practical Guides in Radiation Oncology book series (PGRO)

Abstract

  • Radiotherapy for low-grade gliomas in children has always been controversial due to the high control rates and long potential timeline for the development of late toxicities.

  • The use of effective cytotoxic regimens like carboplatin and vincristine [1], thioguanine, procarbazine, lomustine, and vincristine (TPCV) [2], and single-agent vinblastine [3, 4] means that radiotherapy may often be delayed to a more favorable age allowing for continued normal development.

  • Many children who are not surgical cases will ultimately need radiotherapy for disease control, and thus conformal treatment methods are required.

  • Merchant et al. demonstrated reduced target margin (1 cm CTV) radiotherapy for low-grade gliomas results in excellent disease control and acceptable rates of vasculopathy [5]. ACNS0221 is evaluating the use of 0.5 cm CTV margins for low-grade gliomas, but has not yet been reported.

  • Optic pathway gliomas (OPGs) represent a special case of low-grade glioma and often require treatment due to threatened vision. The response rate of OPGs with vision symptoms is substantial, with greater than 75% having either stabilization or improvement in vision with radiotherapy [6].

  • Radiotherapy is potentially curative in 80–90% of low-grade gliomas; however, given the potential for late effects, radiotherapy is often used as a last resort after progression following multiple chemotherapy or targeted therapy regimens or when vision is threatened.

References

  1. 1.
    Packer RJ, Ater J, Allen J, Phillips P, Geyer R, Nicholson HS, Jakacki R, Kurczynski E, Needle M, Finlay J, Reaman G, Boyett JM (1997) Carboplatin and vincristine chemotherapy for children with newly diagnosed progressive low-grade gliomas. J Neurosurg 86:747–754CrossRefGoogle Scholar
  2. 2.
    Prados MD, Edwards MS, Rabbitt J, Lamborn K, Davis RL, Levin VA (1997) Treatment of pediatric low-grade gliomas with a nitrosourea-based multiagent chemotherapy regimen. J Neuro-Oncol 32:235–241CrossRefGoogle Scholar
  3. 3.
    Bouffet E, Jakacki R, Goldman S, Hargrave D, Hawkins C, Shroff M, Hukin J, Bartels U, Foreman N, Kellie S, Hilden J, Etzl M, Wilson B, Stephens D, Tabori U, Baruchel S (2012) Phase II study of weekly vinblastine in recurrent or refractory pediatric low-grade glioma. J Clin Oncol 30:1358–1363CrossRefGoogle Scholar
  4. 4.
    Cappellano AM, Petrilli AS, Da Silva NS, Silva FA, Paiva PM, Cavalheiro S, Bouffet E (2015) Single agent vinorelbine in pediatric patients with progressive optic pathway glioma. J Neuro-Oncol 121:405–412CrossRefGoogle Scholar
  5. 5.
    Merchant TE, Kun LE, Wu S, Xiong X, Sanford RA, Boop FA (2009) Phase II trial of conformal radiation therapy for pediatric low-grade glioma. J Clin Oncol 27:3598–3604CrossRefGoogle Scholar
  6. 6.
    Tao ML, Barnes PD, Billett AL, Leong T, Shrieve DC, Scott RM, Tarbell NJ (1997) Childhood optic chiasm gliomas: radiographic response following radiotherapy and long-term clinical outcome. Int J Radiat Oncol Biol Phys 39:579–587CrossRefGoogle Scholar
  7. 7.
    Metcalfe P, Chapman A, Arnold A, Arnold B, Tangboonduangjit P, Capp A, Fox C (2004) Intensity-modulated radiation therapy: not a dry eye in the house. Australas Radiol 48:35–44CrossRefGoogle Scholar
  8. 8.
    Parsons JT, Bova FJ, Fitzgerald CR, Mendenhall WM, Million RR (1994) Radiation optic neuropathy after megavoltage external-beam irradiation: analysis of time-dose factors. Int J Radiat Oncol Biol Phys 30:755–763CrossRefGoogle Scholar
  9. 9.
    Stafford SL, Pollock BE, Leavitt JA, Foote RL, Brown PD, Link MJ, Gorman DA, Schomberg PJ (2003) A study on the radiation tolerance of the optic nerves and chiasm after stereotactic radiosurgery. Int J Radiat Oncol Biol Phys 55:1177–1181CrossRefGoogle Scholar
  10. 10.
    Harris JR, Levene MB (1976) Visual complications following irradiation for pituitary adenomas and craniopharyngiomas. Radiology 120:167–171CrossRefGoogle Scholar
  11. 11.
    Chemaitilly W, Li Z, Huang S, Ness KK, Clark KL, Green DM, Barnes N, Armstrong GT, Krasin MJ, Srivastava DK, Pui CH, Merchant TE, Kun LE, Gajjar A, Hudson MM, Robison LL, Sklar CA (2015) Anterior hypopituitarism in adult survivors of childhood cancers treated with cranial radiotherapy: a report from the St Jude Lifetime Cohort study. J Clin Oncol 33:492–500CrossRefGoogle Scholar
  12. 12.
    Murphy ES, Xie H, Merchant TE, Yu JS, Chao ST, Suh JH (2015) Review of cranial radiotherapy-induced vasculopathy. J Neuro-Oncol 122:421–429CrossRefGoogle Scholar
  13. 13.
    Merchant TE, Gould CJ, Wilson MW, Hilton NE, Rodriguez-Galindo C, Haik BG (2004) Episcleral plaque brachytherapy for retinoblastoma. Pediatr Blood Cancer 43:134–139CrossRefGoogle Scholar
  14. 14.
    Kaste SC, Crom DB, Fontanesi J, Mounce KG, Elfervig J, Meyer D, Pratt CB (1994) Orbital development in long-term survivors of retinoblatomsa. International Society for Genetic Eye Disease, Niagra-on-the-LakeGoogle Scholar
  15. 15.
    Egbert PR, Donaldson SS, Moazed K, Rosenthal AR (1978) Visual results and ocular complications following radiotherapy for retinoblastoma. Arch Ophthalmol 96:1826–1830CrossRefGoogle Scholar
  16. 16.
    Duffner PK, Cohen ME, Voorhess ML, Macgillivray MH, Brecher ML, PANAHON A, GILANI BB (1985) Long-term effects of cranial irradiation on endocrine function in children with brain tumors. A prospective study. Cancer 56:2189–2193CrossRefGoogle Scholar
  17. 17.
    Fletcher O, Easton D, Anderson K, Gilham C, Jay M, Peto J (2004) Lifetime risks of common cancers among retinoblastoma survivors. J Natl Cancer Inst 96:357–363CrossRefGoogle Scholar
  18. 18.
    Mouw KW, Sethi RV, Yeap BY, MacDonald SM, Chen YL, Tarbell NJ, Yock TI, Munzenrider JE, Adams J, Grabowski E, Mukai S, Shih HA (2014) Proton radiation therapy for the treatment of retinoblastoma. Int J Radiat Oncol Biol Phys 90:863–869CrossRefGoogle Scholar
  19. 19.
    American Brachytherapy Society—Ophthalmic Oncology Task Force (2014) The American Brachytherapy Society consensus guidelines for plaque brachytherapy of uveal melanoma and retinoblastoma. Brachytherapy 13:1–14CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Radiation OncologySt. Jude Children’s Research HospitalMemphisUSA
  2. 2.Radiation Research Program (RRP), Division of Cancer Treatment and Diagnosis (DCTD)National Cancer Institure (NCI), National Institutes of Health (NIH)BethesdaUSA

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