title: Long-Term Outcomes of Group B Eyes in Patients with Retinoblastoma Treated with Short-Course Chemoreduction: Experience from Children's Hospital Los Angeles/University of Southern California.
abstract: OBJECTIVE
  Chemoreduction protocols for retinoblastoma vary widely across institutions. Herein, we compare a 3- versus 6-cycle chemotherapy approach for group B retinoblastoma.
  
  
  METHODS
  A nonrandomized, retrospective review of patients diagnosed with group B retinoblastoma from 1991-2011 at Children's Hospital Los Angeles was performed. A total of 72 eyes of 63 patients were analyzed. Mean follow-up time was 82 months (range 6-272 months). Main outcome measures were globe salvage and need for external beam radiation.
  
  
  RESULTS
  Forty-six patients (55 eyes) were treated upfront with 3 cycles of carboplatin, etoposide, and vincristine; 17 patients (17 eyes) received 6 cycles. Thirty-seven eyes (67%) in the 3-cycle group were cured with initial chemoreduction alone. An additional 10 eyes with persistent or recurrent tumors were rescued with 3 more cycles for a total salvage rate of 85% (47/55 eyes). In the 6-cycle group, 16 of 17 eyes (94%) avoided radiation and enucleation.
  
  
  CONCLUSIONS
  The initial recurrence rate was higher for the 3-cycle group (p = 0.03). However, eyes failing short-course chemoreduction were rescued with 3 additional cycles and achieved a similar overall event-free survival rate (p = 0.16). In our cohort, this short-course approach spared 63% (29/46) of patients with group B retinoblastoma the extra 3 cycles of systemic chemotherapy.
authors.affiliation: University of Southern California Eye Institute, Calif., USA.
authors.forename: Dagny
authors.initials: D
authors.lastname: Zhu
authors.affiliation: University of Southern California Eye Institute, Calif., USA; The Vision Center at Children's Hospital Los Angeles, Calif., USA.
authors.forename: Jesse L
authors.initials: JL
authors.lastname: Berry
authors.affiliation: University of Southern California Eye Institute, Calif., USA.
authors.forename: Lilangi
authors.initials: L
authors.lastname: Ediriwickrema
authors.affiliation: Radiation Oncology Program, Children's Hospital, Los Angeles, Calif., USA.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Wong
authors.affiliation: University of Southern California Eye Institute, Calif., USA; The Vision Center at Children's Hospital Los Angeles, Calif., USA.
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Lee
authors.affiliation: The Vision Center at Children's Hospital Los Angeles, Calif., USA.
authors.forename: A Linn
authors.initials: AL
authors.lastname: Murphree
authors.affiliation: University of Southern California Eye Institute, Calif., USA; The Vision Center at Children's Hospital Los Angeles, Calif., USA.
authors.forename: Jonathan W
authors.initials: JW
authors.lastname: Kim
authors.affiliation: The Children's Center for Cancer and Blood Diseases, Children's Hospital, Calif., USA.
authors.forename: Rima
authors.initials: R
authors.lastname: Jubran
keywords: Chemotherapy; Pediatric oncology; Retinoblastoma