Chemoreduction for retinoblastoma. Analysis of tumor control and risks for recurrence in 457 tumors.
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.
Shields
Carol L
CL
Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, 840 Walnut Street, Philadelphia, PA 19107, USA. carol.shields@shieldsoncology.com
Mashayekhi
Arman
A
Cater
Jacqueline
J
Shelil
Abdallah
A
Meadows
Anna T
AT
Shields
Jerry A
JA
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*
D014750:Vincristine; D005047:Etoposide; D016190:Carboplatin