Lin Ting-Bin, Kuo Chao-Yang, Chang Feng-Chi, Lin Shih-Chieh, Chen Yi-Wei, Liang Muh-Lii, Lee Yi-Yen
Division of Pediatric Neurosurgery, Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
Graduate Institute of Artificial Intelligence and Big Data in Healthcare, Smart Healthcare Interdisciplinary College, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
Neurooncol Adv. 2025 Jan 29;7(1):vdaf020. doi: 10.1093/noajnl/vdaf020. eCollection 2025 Jan-Dec.
Chemotherapy plays an important role in the treatment of optic pathway hypothalamic gliomas (OPHGs). Commonly used regimens include carboplatin and vincristine and monotherapy with vinblastine weekly. In this retrospective study, we used a monthly regimen of carboplatin and vinblastine to treat progressive/recurrent OPHGs and evaluated their effectiveness, visual preservation, and toxicity.
The study involved patients with OPGH who were treated with carboplatin and vinblastine once per month. The response, disease progression, overall survival, vision changes, and toxicity were recorded according to their medical charts at our institute, and survival was analyzed.
A total of 25 patients were included, including 15 males (60%) and 10 females (40%). The response rate was 11/25 (44%), and the stabilization rate (complete response rate + partial response rate + minor response rate + and stable disease rate) was 21/25 (84%). The 3-year progression-free survival (PFS) rate was 54.6%, and the 5-year PFS rate was 46.8%. The 5-year overall survival rate was 100%. There were 6 patients who showed improved visual acuity (28.6%). Stable vision was found in 52.4% of patients. Only 2 patients experienced severe allergic reactions to carboplatin.
The results showed that extending the dosing interval of carboplatin and vinblastine to every month can be seen as a similar response compared with previous regimens. The toxicity of this regimen is milder, and patients benefit from a lower frequency of hospital visits. The regimen can be considered as a choice of the first line of chemotherapy for OPHG patients.
化疗在视路下丘脑胶质瘤（OPHG）的治疗中起着重要作用。常用方案包括卡铂和长春新碱以及每周一次的长春花碱单药治疗。在这项回顾性研究中，我们采用每月一次的卡铂和长春花碱方案治疗进展性/复发性OPHG，并评估其有效性、视力保留情况和毒性。
本研究纳入了接受每月一次卡铂和长春花碱治疗的OPHG患者。根据我院病历记录患者的反应、疾病进展、总生存期、视力变化和毒性，并对生存期进行分析。
共纳入25例患者，其中男性15例（60%），女性10例（40%）。缓解率为11/25（44%），稳定率（完全缓解率+部分缓解率+轻微缓解率+疾病稳定率）为21/25（84%）。3年无进展生存期（PFS）率为54.6%，5年PFS率为46.8%。5年总生存率为100%。有6例患者视力提高（28.6%）。52.4%的患者视力稳定。仅2例患者对卡铂出现严重过敏反应。
结果表明，将卡铂和长春花碱的给药间隔延长至每月一次，与既往方案相比反应相似。该方案毒性较轻，患者因就诊频率降低而受益。该方案可被视为OPHG患者一线化疗的选择之一。
