Spontaneous Regression of Optic Gliomas

Parsa, Cameron F.; Hoyt, Creig S.; Lesser, Robert L.; Weinstein, Joel M.; Strother, Charles M.; Muci-Mendoza, Rafael; Ramella, Marcos; Manor, Riri S.; Fletcher, William A.; Repka, Michael X.; Garrity, James A.; Ebner, Roberto; Monteiro, Mário Luiz Ribeiro; McFadzean, Robert M.; Rubtsova, Irina V.; Hoyt, William F.

doi:10.1001/archopht.119.4.516

Cited by 265 publications

(41 citation statements)

References 30 publications

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“…We have identified neurofibromatosis and the presence of a visual pathway glioma as important factors in predicting regression, and other studies have gone further, in suggesting that partial treatment may initiate tumor regression. Parsa et al[ 5] suggested that partial tumor debulking, biopsy, radiotherapy or chemotherapy may play a role in initiating tumor apoptosis. Others have further described needle biopsy or minor debulking as instigators to the regression, citing growth factors and other endogenous reactions as the mechanism [7, 13,19,20,21].…”

Section: Discussionmentioning

confidence: 99%

“…Of the factors that have been suggested as positive associations for tumor regression, the association with neurofibromatosis has been the more widely reported. Over 15 reports of the spontaneous regression of low-grade gliomas in association with neurofibromatosis type 1 have been reported [5,6,7,8,9,10,11,12]. The consideration of spontaneous regression is significant, as it would allow a significant number of patients to avoid the side effects of treatment.…”

Section: Introductionmentioning

confidence: 99%

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Spontaneous Regression of Low-Grade Gliomas in Pediatric Patients without Neurofibromatosis

Rozen

Joseph

2008

Pediatr Neurosurg

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Objective: Pediatric low-grade gliomas comprise a diverse range of central nervous system tumors, sharing the usual course of a slow progression in growth. In individual cases however, the natural history can be variable, and rarely spontaneous regression has been described. This paper describes factors associated with spontaneous regression. Methods: A literature review was performed to identify factors associated with spontaneous regression. A unique case is described to contribute to the findings. Results: Low-grade gliomas occurring in association with neurofibromatosis are more likely to spontaneously regress. Only 14 cases of spontaneous regression of low-grade gliomas in patients without neurofibromatosis have been described, and of these, the vast majority regress in association with optic chiasm gliomas. We describe the first documented case of spontaneous regression of a temporal lobe pilocytic astrocytoma in a patient without neurofibromatosis. Conclusion: Spontaneous regression of low-grade gliomas can occur for tumors in a diversity of anatomical locations, at varying ages and in both sexes. This may have implications for management. As such, spontaneous tumor regression is an important outcome to be considered for pediatric low-grade gliomas and pilocytic astrocytomas.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Spontaneous Regression of Low-Grade Gliomas in Pediatric Patients without Neurofibromatosis

Rozen

Joseph

2008

Pediatr Neurosurg

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“…Case reports have even described spontaneous regression of some tumors (Rozen, Joseph & Lo, 2008;Parsa, Hoyt, Lesser, Weinstein, Strother, Hoyt, 2001). This is in contrast to adult…”

Section: Childhoodmentioning

confidence: 99%

Primary CNS Tumors and Leptomeningeal, Disseminated and/or Multicentric Disease in Children Treated in Phase II Studies with Antineoplastons A10 and AS2-1

Burzynski¹,

Janicki²,

Burzynski³

2016

CCO

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It is estimated that as many as 30% of patients with primary CNS tumors have leptomeningeal, disseminated, and/or multicentric disease (LDM). These patients respond poorly to conventional therapy. Fifty-seven children with LDM (median age of 7.1 years) were treated in multiple prospective phase II clinical studies of high-and low-grade primary CNS tumors with Antineoplastons A10 and AS2-1 (ANP). Their inclusion in this analysis was based on MRI imaging. Patients with glioblastoma were excluded. The patients received ANP therapy 6 times daily; A10: 8.77 g/kg/d; AS2-1: 0.35 g/kg/d. The response to ANP was monitored by MRIs every 8 weeks.Patients evaluable for efficacy (N = 40) received 12 or more weeks of ANP or developed progressive disease (PD) before 12 weeks. 10 patients (17.5%) achieved an objective response (OR) with 4 (7%) achieving a complete response (CR) and 6 (10.5%) had a partial response (PR). Stable disease (SD) was maintained in 7 patients (12.3%) and PD developed in 23 patients (40.4%). Survival analysis of the 57 children showed 2-and 5-year overall survival (OS) were both 28% while 10-and 15-year OS were both 26%. One of the patients achieving an OR had atypical teratoid/rhabdoid tumor (AT/RT) while nine had low-grade gliomas (LGGs). Grade 3 and 4 toxicities included hypokalemia (14.0%); fatigue, anemia, hypernatremia and leukopenia (3.5% each); diarrhea, hypertension, joint pain, thrombocytopenia, and somnolence (1.8% each). These findings suggest the need for a single-arm, phase II study of ANP in children with LDM.

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“…Bazı hastalarda tümör kendiliğinden gerileyebilir. 12 Tümör orbitada sınırlıysa, aşırı bir proptozise ve optik atrofiye neden olmuyorsa ve görmeyi tehdit etmiyorsa izlem önerilir. Tedavi yöntemi olarak 5 yaş altı çocuklarda kemoterapi tercih edilebilir.…”

Section: Sonuçlarunclassified

Orbita Nörojenik Tümörlerinin Klinik ve Tedavi Özellikleri

Kızıltunç¹,

Günduz²,

Erden³

2013

tjo

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ÖzetAmaç: Orbita nörojenik tümörlerinin klinik ve tedavi özelliklerinin değerlendirilmesi Ge reç ve Yön tem: Ankara Üniversitesi Tıp Fakültesi Göz Hastalıkları Anabilim Dalı Tümör Bölümü'nde 1998-2011 yılları arasında orbital nörojenik tümör tanısı alan 35 hastanın dosyaları retrospektif olarak tarandı. Sonuçlar: Olguların yaş ortalaması 28.3 yaş (2-67) idi. Başvuruda 20 (%57) olguda proptozis, 11 (%31) olguda göz hareketlerinde kısıtlılık vardı. Olguların 21'ine (%60) cilt yoluyla, 7'sine (%20) konjonktival yolla orbitotomi yapıldı. Olguların 3'ü (%8) daha önce dış merkezde opere edilmişti. 4 (%12) olguya klinik olarak tanı konuldu. Olguların 11'ine (%31,4) total eksizyonel biyopsi, 7'sine (%20) subtotal eksizyonel biyopsi, 10'una (%28,6) insizyonel biyopsi yapıldı. Histopatolojik ve klinik tanıya göre olguların 14'ünde (%40) menenjiom, 12'sinde (%34) periferik sinir kılıfı tümörü, 9'unda (%26) optik sinir gliomu saptandı. Menenjiom olgularının 6'sı (%43) optik sinir kılıf menenjiomu, 5'i (%36) sfenoid kanat menenjiomu, 2'si (%14) ektopik menenjiom, 1'i (%7) perisellar menenjiomdu. Periferik sinir kılıfı tümörlerinin 6'sı ( Ma te ri al and Met hod:The records of 35 patients with orbital neurogenic tumors who were diagnosed and treated at Ankara University Faculty of Medicine, Department of Ophthalmology, between 1998 and 2011 were evaluated retrospectively. Re sults: Orbitotomy via a cutaneous approach was performed in 21 (60%) cases and orbitotomy via a transconjunctival approach was performed in 7 (20%) cases. Three (8%) cases had been operated at different centers. Four (12%) cases were diagnosed clinically. Total excisional biopsy was performed in 11 (31.4%) cases, subtotal excisional biopsy was performed in 7 (20%), and incisional biopsy was performed in 10 (28.6%) cases. 14 (40%) 35 cases were diagnosed as meningioma, 12 (34%) as peripheral nerve sheath tumor, and 9 (26%) cases were diagnosed as optic nerve glioma. Six (43%) meningioma cases were optic nerve sheath meningioma, 5 (36%) were sphenoid wing meningioma, 2 (14%) were ectopic meningioma, and 1 (7%) was perisellar meningioma. Six (50%) of peripheral nerve sheath tumors were schwannoma, 2 (16%) were solitary neurofibroma, 4 (34%) were plexiform neurofibroma. External beam radiotherapy was performed in 15 (42.8%) cases, cyberknife radiosurgery in 1 (2.8%) , chemotherapy in 1 (2.8%), and enucleation ( because of neovascular glaucoma and vitreous hemorrhage) was performed in 1 (2.8%) case. Dis cus si on: The most common orbital neurogenic tumors are meningioma, peripheral nerve sheath tumor, and optic nerve glioma. For meningioma and glioma, external beam radiotherapy is required; for schwannoma and solitary neurofibroma, total excisional biopsy is the preferred treatment. The success of visual and anatomic results are high after treatment. (Turk J Ophthalmol 2013; 43: 335-9)

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Spontaneous Regression of Optic Gliomas

Cited by 265 publications

References 30 publications

Spontaneous Regression of Low-Grade Gliomas in Pediatric Patients without Neurofibromatosis

Spontaneous Regression of Low-Grade Gliomas in Pediatric Patients without Neurofibromatosis

Primary CNS Tumors and Leptomeningeal, Disseminated and/or Multicentric Disease in Children Treated in Phase II Studies with Antineoplastons A10 and AS2-1

Orbita Nörojenik Tümörlerinin Klinik ve Tedavi Özellikleri

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