title: Chemoreduction for retinoblastoma. Analysis of tumor control and risks for recurrence in 457 tumors.
abstract: OBJECTIVE
  To evaluate retinoblastoma control following chemoreduction.
  
  
  METHODS
  Interventional case series.
  
  
  METHODS
  Prospective.
  
  
  METHODS
  Single center trial.
  
  
  METHODS
  457 retinoblastomas in 193 eyes of 125 patients. Nonrandomized, noncomparative study.
  
  
  METHODS
  All patients received intravenous vincristine, etoposide, and carboplatin,. The tumors were managed with chemoreduction alone (group W) or chemoreduction combined with thermotherapy (group X), cryotherapy (group Y), or both thermotherapy and cryotherapy (group Z).
  
  
  METHODS
  Tumor recurrence in each treatment group.
  
  
  RESULTS
  Of 457 retinoblastomas, 63 (14%) were in group W, 256 (56%) in group X, 127 (28%) in group Y, and 11 (2%) in group Z. The tumor was located in the macula in 33 (52%) of group W, 109 (43%) of group X, 3 (2%) of group Y, and 9 (1%) of group Z. The mean tumor thickness at initial examination was 7 mm for group W, 4 mm for group X, 2 mm for group Y, and 3 mm for group Z. Using Kaplan-Meier estimates, recurrence of the individual retinoblastoma at 7 years was found in 45% of group W and 18% for combined groups X, Y, and Z. Risk factors predictive of tumor recurrence by multivariate analysis included macular tumor location for all groups and additionally female gender for group W and increasing tumor thickness for groups X, Y, and Z.
  
  
  CONCLUSIONS
  Chemoreduction alone or combined with cryotherapy or thermotherapy is effective for treatment of retinoblastoma, but tumor recurrence rate is highest for those located in the macula and those with greater thickness.
authors.affiliation: Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, 840 Walnut Street, Philadelphia, PA 19107, USA. carol.shields@shieldsoncology.com
authors.forename: Carol L
authors.initials: CL
authors.lastname: Shields
authors.forename: Arman
authors.initials: A
authors.lastname: Mashayekhi
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Cater
authors.forename: Abdallah
authors.initials: A
authors.lastname: Shelil
authors.forename: Anna T
authors.initials: AT
authors.lastname: Meadows
authors.forename: Jerry A
authors.initials: JA
authors.lastname: Shields
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D017679:Cryotherapy; D005047:Etoposide / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D007223:Infant; D008297:Male; D009364:Neoplasm Recurrence, Local; D011446:Prospective Studies; D019572:Retinal Neoplasms / Q000145:classification / Q000188:drug therapy* / Q000473:pathology; D012175:Retinoblastoma / Q000145:classification / Q000188:drug therapy* / Q000473:pathology; D012307:Risk Factors; D014750:Vincristine / Q000627:therapeutic use*
chemical_list: D014750:Vincristine; D005047:Etoposide; D016190:Carboplatin