Summary of Late Effects after treatment for Optic nerve glioma:
| Late Toxicity |
Neurocognitive problems:
- Poor short term memory
- Difficulty with executive function
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Depression:
- Usually related to multiple long-term health problems and neurocognitive dysfunction
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Seizures:
- Side effect of scarring related to tumor and previous RT therapy
- Responds to anticonvulsant therapy
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Visual problems:
- The disease itself involves the optic apparatus leading to optic atrophy, decreased vision and field defects
- RT may directly damage the optic nerves and chiasm.
- RT can cause cataracts (lens of the eye very sensitive to low dose RT)
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Pituitary and hypothalamic dysfunction:
- RT therapy is likely to result in hypopituitarism..
- Increased risk of Metabolic syndrome (with hypertension)
- BLOOD PRESSURE SHOULD BE CHECKED IN ANY PATIENT WHO HAS A HISTORY OF CRANIAL RT
- GH deficiency is very common with failure to grow in children. Also risk of other hormone deficiencies:
- TSH deficiency
- LH/FSH deficiency
- ACTH deficiency
- During infection, surgery and illness optic glioma survivors are very likely to need support with extra steroid medication
- These patients should be seen by an endocrinologist every year or so who should assess pituitary function and supervise replacement therapy.
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Increased risk for cerebrovascular events (strokes):
- RT effect on cerebral vasculature
- Significantly increased risk of TIAs and cerebrovascular disease in these patients (especially those who have NF1)
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Increased risk of second neoplasms:
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Cranial RT techniques more than 10 years old could be associated with scattered RT to the thyroid with an increased risk of:
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