Nitrosourea-based chemotherapy in optic pathway glioma with progressive visual loss

Purpose: To report two patients with progressive optic pathway gliomas who had reversible visual loss after treatment with nitrosourea-based chemotherapy. Design: Retrospective case series. Results: Two patients with optic pathway gliomas and progressive visual field loss were treated with nitrosourea-based chemotherapy consisting of 6-thioguanine, procarbazine, 1-(2-chloroethyl)-3- cyclohexyl-1-nitrosourea (CCNU), and vincristine (TPCV). Both patients experienced dramatic and sustained visual improvement after treatment. Conclusion: Patients with progressive optic pathway gliomas may benefit from initial therapy with nitrosourea-based chemotherapy. This treatment might delay or avoid the need for radiation therapy and its associated side effects, especially in younger aged children.