Results of combined chemotherapy and radiotherapy for advanced intraocular retinoblastoma

Arch Ophthalmol. 1996 Nov;114(11):1339-43. doi: 10.1001/archopht.1996.01100140539004.

Abstract

Objective: To determine the visual anatomical results and survival after combined chemotherapy and whole eye radiotherapy for patients with bilateral Reese-Ellsworth group V retinoblastoma.

Setting: A national referral center for retinoblastoma.

Patients: Fourteen patients with bilateral Reese-Ellsworth group V retinoblastoma seen between March 1, 1989, and April 30, 1995, were treated.

Interventions: Patients were treated with chemotherapy (using carboplatin, etoposide, and vincristine) and whole eye radiotherapy (40-44 Gy in 20-22 equivalent fractions). A medical record review was performed to determine outcomes.

Main outcome measures: Survival, eye preservation rate, and visual acuity.

Results: Two patients died, 1 from a primitive neuroectodermal tumor and the other from the meningeal spread of retinoblastoma. Four eyes were enucleated primarily because of severe disease at presentation. Of the remaining 20 eyes, 6 required enucleation. The disease recurred in 4 of those patients, and neovascular glaucoma developed in 2 patients. Of the 12 surviving children, 5 have a visual acuity better than l/60 in at least 1 eye.

Conclusion: Although most of the treated group V eyes could be salvaged with chemotherapy plus radiotherapy, the resultant visual acuity was often poor.

MeSH terms

  • Antineoplastic Agents, Phytogenic / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Carboplatin / administration & dosage
  • Child, Preschool
  • Combined Modality Therapy
  • Etoposide / administration & dosage
  • Eye Enucleation
  • Eye Neoplasms / mortality
  • Eye Neoplasms / physiopathology
  • Eye Neoplasms / therapy*
  • Female
  • Glaucoma, Neovascular / etiology
  • Humans
  • Infant
  • Male
  • Neoplasm Recurrence, Local
  • Retinoblastoma / mortality
  • Retinoblastoma / physiopathology
  • Retinoblastoma / therapy*
  • Survival Rate
  • Vincristine / administration & dosage
  • Visual Acuity

Substances

  • Antineoplastic Agents, Phytogenic
  • Vincristine
  • Etoposide
  • Carboplatin