Chemoreduction for intraocular retinoblastoma in Malaysia.
In the last decade, chemotherapy in combination with focal therapy (chemoreduction) has been increasingly used in intraocular retinoblastoma to avoid enucleation and radiotherapy. The aim of this study was to assess the feasibility and outcome of chemoreduction in Malaysian children with retinoblastoma. This was a prospective study from August 2001 to January 2006. Twenty children (25 eyes) were given 4 cycles of chemoreduction, after which the response was assessed. Fourteen eyes showed a complete response, 10 eyes showed a partial response, and 1 eye had progressive disease. Twelve eyes developed progressive disease later, 9 after an initial complete response and 3 after a partial response. Overall, progressive disease occurred in 52%. There were 2 treatment failures, in Reese-Elsworth groups 3 and 4. Both eyes required enucleation. One eye in group 5 required second line chemotherapy to achieve a complete response. No eyes were irradiated. Five children (25%) defaulted follow-up, one of whom returned with disseminated disease. In conclusion, 4 cycles of chemoreduction achieved a durable complete response in only 12% of eyes. Chemoreduction is feasible in Malaysia but requires good patient compliance and close follow-up.
Menon
Bina Sharine
BS
Paediatric Unit, Universiti Putra Malaysia, General Hospital Kuala Lumpur, Jalan Masjid, Kuala Lumpur 50586, Malaysia. drmenon2003@hotmail.com
Juraida
Eni
E
Alagaratnam
Joseph
J
Mohammad
Mahfuzah
M
Ibrahim
Hishamshah
H
George
Tara Mary
TM
Ariffin
Hany
H
Ho
Caroline
C
Khuzaiah
Raja
R
Peng
Lin Hai
LH
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D016190:Carboplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D017679:Cryotherapy; D018572:Disease-Free Survival; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D053685:Laser Therapy; D008296:Malaysia; D008297:Male; D011446:Prospective Studies; D019572:Retinal Neoplasms / Q000628:therapy*; D012175:Retinoblastoma / Q000401:mortality / Q000628:therapy*; D014750:Vincristine / Q000008:administration & dosage
D014750:Vincristine; D005047:Etoposide; D016190:Carboplatin