The International Classification of Retinoblastoma predicts chemoreduction success.
OBJECTIVE
To evaluate the reliability of the International Classification of Retinoblastoma (ICRB) for predicting treatment success with chemoreduction (CRD).


METHODS
Noncomparative interventional case series.


METHODS
Two hundred forty-nine consecutive eyes.


METHODS
All eyes were treated with CRD and were classified according to the ICRB: group A included those eyes with retinoblastoma </=3 mm; group B included those eyes with retinoblastoma >3 mm, macular location, or minor subretinal fluid; group C included those eyes with retinoblastoma with localized seeds; group D included those eyes with retinoblastoma with diffuse seeds; group E included those eyes with massive retinoblastoma necessitating enucleation. The CRD regimen included vincristine, etoposide, and carboplatin for 6 cycles plus local consolidation with thermotherapy or cryotherapy.


METHODS
Chemoreduction success, defined as avoidance of external beam radiotherapy or enucleation.


RESULTS
Of the 249 eyes, 23 (9%) were in group A, 96 (39%) were in group B, 21 (8%) were in group C, and 109 (44%) were in group D. In this series, group E eyes were managed with enucleation. Treatment success was achieved in 100% of group A, 93% of group B, 90% of group C, and 47% of group D eyes.


CONCLUSIONS
The ICRB can be of assistance in predicting CRD success for retinoblastoma. Additional treatment methods are necessary to salvage more group D eyes.
Shields
Carol L
CL
Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
Mashayekhi
Arman
A
Au
Angela K
AK
Czyz
Craig
C
Leahey
Ann
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; D006801:Humans; D006979:Hyperthermia, Induced; D007223:Infant; D038801:International Classification of Diseases; D015203:Reproducibility of Results; D019572:Retinal Neoplasms / Q000145:classification* / Q000188:drug therapy* / Q000473:pathology; D012175:Retinoblastoma / Q000145:classification* / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome; D014750:Vincristine / Q000627:therapeutic use
D014750:Vincristine; D005047:Etoposide; D016190:Carboplatin