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Optic Pathway Glioma

 

 

Late Effects

 

Summary of Late Effects after treatment for Optic nerve glioma:

Late Toxicity

Neurocognitive problems:

  • Poor short term memory
  • Difficulty with executive function

Depression:

  • Usually related to multiple long-term health problems and neurocognitive dysfunction

Seizures:

  • Side effect of scarring related to tumor and previous RT therapy
  • Responds to anticonvulsant therapy

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)

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.

 

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)

Increased risk of second neoplasms:

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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