title: Chemoreduction followed by local therapy and adjuvant chemotherapy for advanced intraocular retinoblastoma: a pilot study in a single center.
abstract: Intraocular (IO) retinoblastoma (RB) has traditionally been treated with enucleation (ENU) or external beam radiotherapy (EBRT). Recently, clinical trials are in progress to cure RB without ENU or EBRT in order to salvage the globe and to avoid unacceptable side effects of EBRT. We performed a pilot study to treat patients with advanced Reese-Ellsworth (RE) stage IO RB with initial chemotherapy (CRx) followed by local therapy (LT) and adjuvant CRx. Ten eyes (8 RE group V, 2 RE group IV) from 9 patients were enrolled from March 2001 to November 2001. All tumors responded to CRx. In 5 of 10 eyes, the RB was enough to be treated with LT after chemoreduction. One patient who underwent LT is waiting for ENU due to post-cryotherapy complication. For a median follow-up of 13 months (8-16 mo), 4 eyes that received LT and adjuvant CRx were relapse-free. A patient with bilateral RB who failed to be a candidate for LT was rescued with high-dose CRx and hematopoietic stem cell transplantation. Consequently, by treating patients according to our strategy, we were able to salvage 6 out of 10 eyes without ENU or EBRT. These results suggest that chemoreduction followed by LT and adjuvant CRx might offer the opportunity to salvage the globe and vision even in patients with advanced stage IO RB.
authors.affiliation: Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. hhkoo@smc.samsung.co.kr
authors.forename: Keon Hee
authors.initials: KH
authors.lastname: Yoo
authors.forename: Woo Yun
authors.initials: WY
authors.lastname: Sohn
authors.forename: Ki Woong
authors.initials: KW
authors.lastname: Sung
authors.forename: Hye-Lim
authors.initials: HL
authors.lastname: Jung
authors.forename: Hong Hoe
authors.initials: HH
authors.lastname: Koo
authors.forename: Sei Yeul
authors.initials: SY
authors.lastname: Oh
authors.forename: Se Woong
authors.initials: SW
authors.lastname: Kang
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D002675:Child, Preschool; D003520:Cyclophosphamide / Q000627:therapeutic use; D015251:Epirubicin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010865:Pilot Projects; D019572:Retinal Neoplasms / Q000188:drug therapy*; D012175:Retinoblastoma / Q000188:drug therapy*; D013997:Time Factors; D014750:Vincristine / Q000627:therapeutic use
chemical_list: D015251:Epirubicin; D014750:Vincristine; D003520:Cyclophosphamide