Division of Ophthalmology, The Children's Hospital of Philadelphia.
Department of Ophthalmology.
Curr Opin Ophthalmol. 2019 Sep;30(5):356-363. doi: 10.1097/ICU.0000000000000587.
Optic pathway gliomas are low-grade neoplasms that affect the precortical visual pathway of children and adolescents. They can affect the optic nerve, optic chiasm, optic tracts and radiations and can either be sporadic or associated with neurofibromatosis type one. Gliomas isolated to the optic nerve (ONG) represent a subgroup of optic pathway gliomas, and their treatment remains controversial. New developments in ONG treatment have emerged in recent years, and it is necessary for clinicians to have a current understanding of available therapies.
The current review of the literature covers the background of and recent developments in ONG treatment, with a focus on standard chemotherapy, new molecularly targeted therapies, radiation therapy and surgical resection and debulking.
Although standard chemotherapy remains the mainstay of ONG treatment, newer molecularly targeted therapies such as mitogen-activated protein kinase kinase inhibitors and bevacizumab represent a promising new treatment modality, and clinical studies are ongoing.
视路胶质瘤是一种低级别肿瘤,影响儿童和青少年的皮质前视路。它们可以影响视神经、视交叉、视束和放射状纤维,并且可以是散发性的,也可以与 1 型神经纤维瘤病相关。孤立于视神经(ONG)的胶质瘤是视路胶质瘤的一个亚组,其治疗仍然存在争议。近年来,ONG 治疗出现了新的发展,临床医生有必要了解现有的治疗方法。
本文献复习涵盖了 ONG 治疗的背景和最新进展,重点介绍了标准化疗、新的分子靶向治疗、放射治疗以及手术切除和减瘤术。
尽管标准化疗仍然是 ONG 治疗的主要方法,但新型的分子靶向治疗,如丝裂原活化蛋白激酶激酶抑制剂和贝伐单抗,代表了一种有前途的新治疗方式,并且正在进行临床研究。