Eye-preserving therapy in retinoblastoma: prolonged primary chemotherapy alone or combined with local therapy.
OBJECTIVE
To evaluate the efficacy of primary chemotherapy combined with local therapy in the treatment of retinoblastomas not treatable with a single therapeutic method.


METHODS
We performed a retrospective chart review of 227 patients diagnosed with retinoblastoma. Sixty-five eyes in 52 patients had tumors not treatable with a single therapeutic method and received primary chemotherapy combined with local therapy as needed.


RESULTS
Tumor control and eye salvage was achieved in 34 of the 65 eyes; the probability of ocular survival was 46.56% using the Kaplan-Meier method. Forty-three of the 65 eyes were group D or E tumors, in which tumor control and eye salvage was achieved in 16 eyes. Twenty eyes were treated with chemotherapy only, while 28 eyes received one additional modality of local therapy, and 17 eyes received two modalities of local therapy. Of the eyes treated with chemotherapy only, tumor control was achieved in 5 eyes.


CONCLUSIONS
Primary chemotherapy combined with local therapy can be effective and safe in the treatment of retinoblastomas otherwise untreatable with other therapeutic methods, such as group D and E retinoblastomas. More vigorous treatment with more local therapeutic methods combined may yield even better results.
Shin
Joo Young
JY
Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.
Kim
Jeong Hun
JH
Yu
Young Suk
YS
Khwarg
Sang In
SI
Choung
Ho Kyung
HK
Shin
Hee Young
HY
Ahn
Hyo Seop
HS
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002675:Child, Preschool; D017679:Cryotherapy / Q000379:methods*; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D007223:Infant; D007231:Infant, Newborn; D017075:Laser Coagulation / Q000379:methods*; D008297:Male; D009887:Ophthalmoscopy; D019572:Retinal Neoplasms / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D012175:Retinoblastoma / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014792:Visual Acuity
D000970:Antineoplastic Agents