title: The International Classification of Retinoblastoma predicts chemoreduction success.
abstract: 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.
authors.affiliation: Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
authors.forename: Carol L
authors.initials: CL
authors.lastname: Shields
authors.forename: Arman
authors.initials: A
authors.lastname: Mashayekhi
authors.forename: Angela K
authors.initials: AK
authors.lastname: Au
authors.forename: Craig
authors.initials: C
authors.lastname: Czyz
authors.forename: Ann
authors.initials: A
authors.lastname: Leahey
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; 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
chemical_list: D014750:Vincristine; D005047:Etoposide; D016190:Carboplatin