[Clinical therapeutic efficiency of chemoreduction and local therapy for children with retinoblastoma].
OBJECTIVE
To evaluate the therapeutic efficiency of customized combined therapy for retinoblastoma.


METHODS
Retrospective case series. Twenty nine patients (40 eyes) with retinoblastoma were accepted customized combined therapy between Jan. 2005 and Dec. 2007 in our hospital. The combined therapy included chemoreduction using vincristine, etoposide, and carboplatin (VEC) combined with local cryotherapy and/or transpupillary thermotherapy (TTT). The average follow-up duration was 38 months and ranging from 12 to 50 months.


RESULTS
Twenty five patients had bilateral retinoblastoma, 4 patients had unilateral retinoblastoma. The stages of 40 eyes were classified according to the International Intraocular Retinoblastoma Classification, 14 eyes (35%) were group A, 9 eyes (22.5%) were group B, 4 eyes (10%) were group C, 10 eyes (25%) were group D, and 3 eyes (7.5%) were group E. Seventeen eyes had vitreous and/or subretinal seeds. The overall globe preservation rate was 75% (30/40); and was 100% (14/14) in group A, 100% (9/9) in group B, 75% (3/4) in group C, 40% (4/10) in group D and 0% (0/3) in group E. A progressive decrease of globe preservation rate was observed in eyes with advanced stages. Tumor recurrence was detected in 4 eyes after chemoreduction, leading to the enucleation. Ten eyes were enucleated in the present series, with 1 eye in group C, 6 eyes in group D and 3 eyes in group E. None of 29 patients died during the follow-up. No patients had any serious side effect of chemotherapy such as leukemia.


CONCLUSIONS
The customized combined therapy can effectively preserve certain patients' eyeballs and even obtain useful visual function. The International Intraocular Retinoblastoma Classification is useful in the clinical management of retinoblastoma.
Qian
Jiang
J
Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai 200031, China. qianjiang58@126.com
Xue
Kang
K
Gao
Yi-jin
YJ
Yuan
Yi-fei
YF
Shan
Hai-dong
HD
Bi
Ying-wen
YW
D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D017679:Cryotherapy; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D007223:Infant; D008297:Male; D009367:Neoplasm Staging; D019572:Retinal Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000628:therapy*; D012175:Retinoblastoma / Q000188:drug therapy / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome