Results of combined chemotherapy and radiotherapy for advanced intraocular retinoblastoma.
OBJECTIVE
To determine the visual anatomical results and survival after combined chemotherapy and whole eye radiotherapy for patients with bilateral Reese-Ellsworth group V retinoblastoma.


METHODS
A national referral center for retinoblastoma.


METHODS
Fourteen patients with bilateral Reese-Ellsworth group V retinoblastoma seen between March 1, 1989, and April 30, 1995, were treated.


METHODS
Patients were treated with chemotherapy (using carboplatin, etoposide, and vincristine) and whole eye radiotherapy (40-44 Gy in 20-22 equivalent fractions). A medical record review was performed to determine outcomes.


METHODS
Survival, eye preservation rate, and visual acuity.


RESULTS
Two patients died, 1 from a primitive neuroectodermal tumor and the other from the meningeal spread of retinoblastoma. Four eyes were enucleated primarily because of severe disease at presentation. Of the remaining 20 eyes, 6 required enucleation. The disease recurred in 4 of those patients, and neovascular glaucoma developed in 2 patients. Of the 12 surviving children, 5 have a visual acuity better than l/60 in at least 1 eye.


CONCLUSIONS
Although most of the treated group V eyes could be salvaged with chemotherapy plus radiotherapy, the resultant visual acuity was often poor.
Department of Paediatric Oncology, St. Bartholomew's Hospital, London, England.
J E
JE
Kingston
J L
JL
Hungerford
S A
SA
Madreperla
P N
PN
Plowman
D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005047:Etoposide / Q000008:administration & dosage; D015353:Eye Enucleation; D005134:Eye Neoplasms / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D015355:Glaucoma, Neovascular / Q000209:etiology; D006801:Humans; D007223:Infant; D008297:Male; D009364:Neoplasm Recurrence, Local; D012175:Retinoblastoma / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D015996:Survival Rate; D014750:Vincristine / Q000008:administration & dosage; D014792:Visual Acuity
D000972:Antineoplastic Agents, Phytogenic; D014750:Vincristine; D005047:Etoposide; D016190:Carboplatin