LGG-29. TREATMENT FOR RECURRENT OPTIC PATHWAY PILOCYTIC ASTROCYTOMA

Chemotherapy after biopsy or partial resection of the tumor is widely accepted as first-line therapy for optic pathway pilocytic astrocytoma. However, there is no standard of care for recurred tumors. We investigated our cases which showed recurrence after initial therapy. Retrospective analysis of four recurrent optic pathway pilocytic astrocytoma cases was performed. All patients underwent partial resection or biopsy of the tumor, and all received carboplatin and etoposide- based chemotherapy as initial treatment. Mean age at first therapy was 2.3 years old, and mean time from initial therapy to recurrence of the tumor was 5.6 years. Two patients were totally blind at the time of recurrence, and other two had partial visual field losses. One patient underwent total resection of the tumor, and other three patients underwent partial resection followed by chemotherapy. Visual function in patients with visual acuity did not deteriorate after removal of the recurrent tumor. There was no recurrence of the tumor who underwent total resection. All of the three patients who had partial resection followed by chemotherapy recurred. Mean time from first recurrence to second recurrence was 1.8 years. After second recurrence, all patients underwent radiation therapy. One patient died due to malignant transformation of the tumor. For recurrent optic pathway pilocytic astrocytoma, prognosis may be better if total resection of the tumor without deteriorating the vision is possible.