title: Low-Dose Chemoreduction for Infants Diagnosed with Retinoblastoma before 6 Months of Age.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the outcomes of infants diagnosed with retinoblastoma before 6 months of age, including the need for chemoreduction (CRD). In this age group, dosage of CRD was reduced due to its potential for toxicity.
  
  
  METHODS
  This is a retrospective review from 2000 to 2009 that includes 126 eyes of 72 infants (18 unilateral, 54 bilateral). Systemic CRD was administered when local modalities failed or were considered inadequate. Primary outcome measures were the need for CRD and globe salvage.
  
  
  RESULTS
  Of the 72 infants diagnosed before 6 months of age, 48 (67%) ultimately required CRD for globe salvage, 40 (56%) patients before 6 months of age. Globe salvage was achieved in 62% (78/126) of eyes overall and in 93% (68/73) of eyes with Group A-C disease. No patient was hospitalized for CRD-related illness; survival was 100%. The mean follow-up was 52.9 months (range 1-148 months).
  
  
  CONCLUSIONS
  Utilizing a combination of focal modalities and reduced-dose CRD, children diagnosed with retinoblastoma before 6 months of age attain globe salvage rates comparable to those of older age groups. Two thirds of the infants ultimately required CRD for globe salvage. Bilateral disease as well as Group D and E classification in at least one eye at presentation increased the chance of requiring CRD (p < 0.0001 and p < 0.016, respectively).
authors.affiliation: The Vision Center, Children's Hospital Los Angeles, USC Eye Institute, Los Angeles, Calif., USA.
authors.forename: Jesse L
authors.initials: JL
authors.lastname: Berry
authors.affiliation: The Children's Center for Cancer and Blood Diseases, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, Calif., USA.
authors.forename: Rima
authors.initials: R
authors.lastname: Jubran
authors.affiliation: The Vision Center, Children's Hospital Los Angeles, USC Eye Institute, Los Angeles, Calif., USA.
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Lee
authors.affiliation: The Vision Center, Children's Hospital Los Angeles, USC Eye Institute, Los Angeles, Calif., USA.
authors.forename: A Linn
authors.initials: AL
authors.lastname: Murphree
authors.affiliation: Georgetown University School of Medicine, Washington, D.C., USA.
authors.forename: Diana
authors.initials: D
authors.lastname: Lee
authors.affiliation: The Vision Center, Children's Hospital Los Angeles, USC Eye Institute, Los Angeles, Calif., USA.
authors.forename: Jonathan W
authors.initials: JW
authors.lastname: Kim
keywords: 6 months of age; Chemoreduction; Chemotherapy; Infants; Neonates; Retinoblastoma; Treatment outcomes