Glioma of the anterior visual pathway in children. Part II. Current treatment trends

Abstract

The literature review presents modern treatment aspects for anterior optic pathway gliomas (OPGs), which are low-grade brain tumors accounting for 20%–30% of childhood gliomas, can occur anywhere along the visual pathways and in the development of the surrounding structure, and are predominantly benign. The predominant histological type of tumor in this localization is piloid astrocytoma (PA), less commonly pilomyxoid astrocytoma (PMA). However, the course of anterior OPGs is unpredictable and varies from spontaneous regression to progression with severe visual, neurological, and endocrine disorders, affecting treatment and disease prognosis. Although there have been advances in clinical studies based on histological and molecular genetic analyses, no fundamental changes in survival rates and recurrence-free periods and improvements in functional outcomes have been achieved. Furthermore, no studies have comprehensively analyzed the functional results depending on the management tactics of pediatric patients with anterior visual pathway gliomas. Anterior optic pathway glioma treatment is challenging and complex problem, which depends on the patient’s age, clinical picture, localization, surgical resectability, and histological and molecular genetic study results. It includes surgical treatment, chemotherapy, radiation therapy, the use of targeted therapy drugs, and additional advanced techniques that are still under development and research. Optimal treatment of anterior optic pathway gliomas in children remains a topic of discussion in the current literature.