Multiagent chemotherapy as neoadjuvant treatment for multifocal intraocular retinoblastoma☆
Section snippets
Material and methods
A single-armed prospective clinical trial was designed to test the hypothesis that multifocal intraocular retinoblastoma can be treated with primary systemic chemotherapy with carboplatin and vincristine. The Institutional Review Board at St. Jude Children’s Research Hospital approved the protocol. Before enrollment, an examination under anesthesia (EUA) was performed to confirm the diagnosis of multifocal intraocular retinoblastoma involving one or both eyes. Fundus drawings were made, and the
Results
Twenty consecutive patients with multifocal intraocular retinoblastoma were treated with primary combination chemotherapy using carboplatin and vincristine between January 1996 and December 1999 (Table 1). Fourteen patients had bilateral disease, and six patients had unilateral disease, two of which progressed to bilateral disease after completing chemotherapy. In total, 36 eyes were followed. Fifteen patients were male and five patients were female. The median age at diagnosis was 8 months
Discussion
Previous studies have investigated the use of combination chemotherapy as a primary treatment for intraocular retinoblastoma.4, 5, 6, 7, 8 Protocols using various combinations of carboplatin, vincristine, etoposide, teniposide, and cyclosporine have been intermixed with focal ophthalmic therapies, including argon laser photocoagulation, cryotherapy, diode laser hyperthermia, I125 episcleral plaque brachytherapy, and EBRT.
In a preliminary report, Shields et al4 used two cycles of carboplatin,
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Supported by Grant NCI CA23099, Cancer Center Support Grant 21765, ALSAC, Research to Prevent Blindness, Inc, New York, New York, St. Giles Foundation, New York, New York.