Conservative Therapy in Intraocular Retinoblastoma

Schiavetti, Amalia; Hadjistilianou, Theodora; Clerico, Aldo; Bonci, Enea; G, Ragni; Castello, Manuel A.

doi:10.1097/01.mph.0000149238.60772.7f

Cited by 22 publications

(16 citation statements)

References 24 publications

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“…Schiavetti et al 55 treated 59 eyes of 45 patients not eligible for local ophthalmic therapy alone with their etoposide and carboplatin chemoreduction and following local therapies. Four to eight courses were given every 21-28 days, depending on tumor response.…”

Section: Chemoreduction With Etoposide and Carboplatin Regimenmentioning

confidence: 99%

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Systemic chemotherapy as a new conservative treatment for intraocular retinoblastoma

Yanagisawa

2004

International Journal of Clinical Oncology

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Retinoblastoma is the most common malignant intraocular tumor in childhood. With advances in the methods for early detection of this disease, the survival rate is over 90% in developed countries. The management of intraocular retinoblastoma has gradually changed over the past few decades. Every effort has been made to save life, with the preservation of the eye and sight, if possible. External beam radiotherapy has been a standard treatment for medium and large, or visually threatening, intraocular retinoblastoma, but it markedly increases the risk of cosmetic deformities and secondary cancer in children with germline RB mutations. For the past decade, primary systemic chemotherapy called "chemoreduction" has been employed to avoid radiotherapy and enucleation. This article gives an overview of the results of current trials of primary chemoreduction for intraocular retinoblastoma, and discusses its role and its limitations in conservative treatment. The article also discusses future directions to expand the indications for this treatment. Many children with advanced intraocular retinoblastoma could be spared external beam radiotherapy and enucleation, mostly as a result of chemoreduction and focal methods. Chemoreduction combined with focal treatments will continue to play an important role in the conservative management of children with intraocular retinoblastoma, possibly even in children with advanced disease, with the combined use of multidrug-resistance modulators.

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Section: Chemoreduction With Etoposide and Carboplatin Regimenmentioning

confidence: 99%

“…Most current studies have used vincristine, etoposide, and carboplatin (VEC regimen). [45][46][47][48][49][50][51] Other regimens, such as etoposide and carboplatin, [53][54][55][56] vincristine and carboplatin, 57 and carboplatin alone, 58 have also been employed.…”

Section: Chemoreductionmentioning

confidence: 99%

Systemic chemotherapy as a new conservative treatment for intraocular retinoblastoma

Yanagisawa

2004

International Journal of Clinical Oncology

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“…Beck et al 36 administered CRD less frequently than our CRD protocol, using 4-week intervals but the same etoposide dosage and twice the carboplatin dosage, and avoided enucleation or EBRT in 63.6% of 33 eyes. Schiavetti et al 42 also used twice the carboplatin but half the etoposide dosage than our CRD protocol and achieved chemotherapy success without using enucleation or EBRT in 50% of 58 eyes. Lumbroso-Le Rouic et al 46 could successfully avoid EBRT and enucleation in 68.7% of their retinoblastoma patients using a chemotherapy regimen consisting of two cycles of CRD (an equivalent dose of carboplatin and 50% of the etoposide dosage per cycle in comparison with our protocol) followed by focal ocular therapy plus thermochemotherapy using carboplatin only.…”

Section: Discussionmentioning

confidence: 87%

Chemoreduction improves eye retention in patients with retinoblastoma: a report from the German Retinoblastoma Reference Centre

et al. 2013

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“…With the tumor shrinkage, supplemental therapies including transpupillary thermotherapy and cryotherapy, usually become more effective. Several studies indicate that most of the early stages and some of the advanced stages of intraocular RBLs may benefit significantly from this type of treatment [17][18][19][20][21][22][23][24].…”

Section: Discussionmentioning

confidence: 99%

The Treatment of Retinoblastoma with Four-Drug Regimen Including Cisplatin, Etoposide, Vincristine, and Cyclophosphamide

Varan

Kıratlı

Aydın

et al. 2012

Pediatric Hematology and Oncology

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Over an 11-year period, 59 patients (83 eyes) were treated with four-drug chemotherapy (cisplatin, etoposide, cyclophosphamide, and vincristine) at Hacettepe University, Departments of Ophthalmology and Pediatric Oncology. We evaluated the clinical features, treatment modalities, and outcome of these patients with a median follow-up of 55 months (range 9-130 months). Enucleation was performed as a first-line treatment for 30 eyes due to iris neovascularization and neovascular glaucoma, tumor in the anterior chamber regardless of the tumor stage, and for the patients with the Reese-Ellsworth (RE) group Vb. Chemotherapy was given regardless of tumor stages according to the RE groups in all 59 patients (83 eyes). Fifty-three eyes were treated with chemoreduction (CRD) and focal treatment. The rates of globe preservation were 87% for bilateral tumors and 35% for unilateral tumors in the CRD group. The 5-year overall (OS) and enucleation-free survival (EnFS) was 86.9% and 40%, respectively, for the whole group. At 3rd year, ocular survival rate for the eyes with vitreal or subretinal seeding was 58% and without seeding was 66% (P = .78). Seeding or subretinal collection may not indicate poor prognosis under intensive chemotherapy. The intensive four-drug chemotherapy protocol might have satisfactory results in the retinoblastoma (RBL) patients.

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Conservative Therapy in Intraocular Retinoblastoma

Cited by 22 publications

References 24 publications

Systemic chemotherapy as a new conservative treatment for intraocular retinoblastoma

Systemic chemotherapy as a new conservative treatment for intraocular retinoblastoma

Chemoreduction improves eye retention in patients with retinoblastoma: a report from the German Retinoblastoma Reference Centre

The Treatment of Retinoblastoma with Four-Drug Regimen Including Cisplatin, Etoposide, Vincristine, and Cyclophosphamide

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