title: MRI findings at baseline and after neoadjuvant chemotherapy in orbital retinoblastoma (IRSS stage III).
abstract: BACKGROUND
  Published findings on MRI results in retinoblastoma patients treated with neoadjuvant chemotherapy (NACT) are lacking. The present study evaluates the role of MRI in International Retinoblastoma Staging System (IRSS) stage III retinoblastoma treated with NACT.
  
  
  METHODS
  28 consecutive IRSS stage III retinoblastoma patients underwent MRI at baseline and after three cycles of NACT prior to enucleation. MRI films were reviewed retrospectively by an ophthalmic radiologist who was masked to patient outcome. Optic nerves were staged based on their thickness, contrast enhancement and length of involvement on MRI. Response evaluation criteria were based on optic nerve staging and changes in the size of the orbital mass on MRI after NACT.
  
  
  RESULTS
  The proposed staging at baseline and after NACT was able to predict event-free-survival (EFS) (p=0.005 and p <0.001, respectively) and overall survival (OS) (p=0.002 and p=0.001, respectively) using the log-rank test for trends. Patients with complete or partial response according to the proposed response evaluation criteria had significantly better EFS (p<0.001) and OS (p=0.024) than those who had stable or progressive disease.
  
  
  CONCLUSIONS
  The proposed MRI based optic nerve staging system and response evaluation criteria were able to predict EFS and OS at baseline and after NACT.
authors.affiliation: Department of Medical Oncology, Dr B. R. A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi 110029, India.
authors.forename: Venkatraman
authors.initials: V
authors.lastname: Radhakrishnan
authors.forename: Sanjay
authors.initials: S
authors.lastname: Sharma
authors.forename: Sreenivas
authors.initials: S
authors.lastname: Vishnubhatla
authors.forename: Sameer
authors.initials: S
authors.lastname: Bakhshi
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005047:Etoposide / Q000627:therapeutic use; D015353:Eye Enucleation; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D019574:Optic Nerve Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000556:secondary*; D009915:Orbit / Q000473:pathology*; D011446:Prospective Studies; D011882:Radiotherapy, High-Energy; D019572:Retinal Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D012175:Retinoblastoma / Q000188:drug therapy / Q000401:mortality / Q000556:secondary*; D015996:Survival Rate; D014750:Vincristine / Q000627:therapeutic use
chemical_list: D014750:Vincristine; D005047:Etoposide; D016190:Carboplatin