Successful treatment with ranimustine and carboplatin for recurrent intraocular retinoblastoma with vitreous seeding.
This is the first report of successful treatment of recurrent retinoblastoma with vitreous seeding by a combination of ranimustine (MCNU) and carboplatin. The patient was diagnosed with bilateral retinoblastoma at 3 years of age. Although he received photocoagulation and radiotherapy for the left eye after enucleation of the right eye, a recurrent tumor associated with vitreous seeding developed 6 years later. The child underwent chemotherapy with cyclophosphamide and nimustine hydrochloride (ACNU), and a transient decrease of tumor cells in the vitreous was seen. We then changed the chemotherapy regimen to MCNU (70 mg/m2/ day for 1 day) and carboplatin (400 mg/m2/day for 2 days). After five courses of this chemotherapy, the tumor in the vitreous completely disappeared. No recurrence has been observed for > 4 years. Side effects, including myelosuppression, general fatigue, and vomiting, were observed during the course of chemotherapy, but they were ameliorated with supportive therapy. Neither nephro- nor ototoxicity was observed. The patient has useful vision. These results warrant further study of this novel drug combination in patients with recurrent, or even primary, retinoblastoma.
Ishii
E
E
Department of Pediatrics, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Matsuzaki
A
A
Ohnishi
Y
Y
Kai
T
T
Ueda
K
K
D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001853:Bone Marrow / Q000187:drug effects; D016190:Carboplatin / Q000008:administration & dosage* / Q000009:adverse effects; D002675:Child, Preschool; D003520:Cyclophosphamide / Q000008:administration & dosage; D005134:Eye Neoplasms / Q000188:drug therapy*; D005221:Fatigue / Q000139:chemically induced; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D009366:Neoplasm Seeding; D015376:Nimustine / Q000008:administration & dosage; D009607:Nitrosourea Compounds / Q000008:administration & dosage* / Q000009:adverse effects; D012175:Retinoblastoma / Q000188:drug therapy*; D014785:Vision, Ocular; D014822:Vitreous Body / Q000187:drug effects / Q000473:pathology*; D014839:Vomiting / Q000139:chemically induced
D000970:Antineoplastic Agents; D018906:Antineoplastic Agents, Alkylating; D009607:Nitrosourea Compounds; D015376:Nimustine; D003520:Cyclophosphamide; D016190:Carboplatin; C020766:ranimustine