Cryotherapy of Retinoblastoma

Tolentino, Felipe I.; Tablante, Ronald T.

doi:10.1001/archopht.1972.01000020054011

Cited by 24 publications

(7 citation statements)

References 4 publications

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“…Under this classification, the smallest tumor size considered is four disc diameters, which is approximately 6 mm. A tumor of this size cannot be managed with focal treatment alone, while tumors that are 3 mm or less in diameter may be treated with cryo 7 or laser techniques alone. 6 , 14 This evidence is linked with the observation that tumors less than 3 mm in size have a better prognosis, 29 rendering Murphree’s ABC classification 19 more appropriate.…”

Section: Discussionmentioning

confidence: 99%

“… 1 While enucleation of the affected eye is curative for intraocular tumors, the therapeutic approach for retinoblastoma treatment has undergone changes in recent years in an attempt to preserve the eye, and thus maintain some degree of vision. Presently, the control of small tumors may be achieved through focal therapy, transpupillary thermotherapy (TTT), 2 – 5 photocoagulation, 6 cryotherapy 7 – 8 and radioactive plaque techniques. 9 Retinoblastoma is highly vulnerable to external beam radiation (EBRT) which, for many years, served as the only conservative treatment available for large tumors.…”

Section: Introductionmentioning

confidence: 99%

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Retinoblastoma: A Three-Year-Study at a Brazilian Medical School Hospital

Bonanomi

Almeida

Cristófani

et al. 2009

Clinics

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OBJECTIVE: To present the characteristics and treatment outcomes of patients with retinoblastoma. METHODS: A retrospective case series was conducted to review the records of all new patients diagnosed with retinoblastoma between 2003 and 2005. Eyes with early disease, or advanced disease with potential vision were treated with chemotherapy (carboplatin and etoposide) in conjunction with early local therapy (laser or cryo). Radiotherapy was used in cases where the disease did not respond to the above protocols or in recurrent cases. Eyes in the late stage of disease with no potential vision in the initial examination or eyes and where conservative treatment had failed were enucleated. RESULTS: In total, we reviewed 28 new cases of retinoblastoma, 15 of which were unilateral and 13 of which were bilateral (46%). These data correspond to a mean of 9.3 new cases per year (0.77 case/ month). The mean age at diagnosis was 33.8 months for unilateral cases, and 19.15 months for bilateral cases (p=0.015). Leucocoria was the major presenting symptom (75%). All but one patient with unilateral disease had the affected eye enucleated due to advanced disease (mean follow-up: 39.91 months). Among the 13 bilateral cases, 13 eyes (50%) were enucleated, 11 eyes (42.4%) were saved with chemotherapy in conjunction with local therapy and 2 eyes (7.6%) were saved using external beam radiotherapy (mean follow-up: 41.91 months). In unilateral and bilateral disease, pathology data revealed choroid involvement in 50% and 30%, respectively, and optic nerve invasion in 92% and 50%, respectively. CONCLUSION: In this population, retinoblastoma was diagnosed too late and most eyes were consequently enucleated. In cases with bilateral disease, half of the eyes were preserved

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Retinoblastoma: A Three-Year-Study at a Brazilian Medical School Hospital

Bonanomi

Almeida

Cristófani

et al. 2009

Clinics

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“…28 Bilateral disease shows asymmetrical involvement, with 1 eye usually having more advanced disease. If there is no potential for useful vision, common practice is to enucleate the eye with more advanced disease and to treat the fellow eye with conservative treatment such as cryotherapy, [6][7][8] and chemotherapy. [11][12][13][14][15][16][17] In this series, 5 eyes (27%) with group V disease required enucleation, whereas the fellow eyes (1 in group Ia and 4 in group IIb) were treated conservatively.…”

Section: Retinoblastoma In Pakistan Discussionmentioning

confidence: 99%

“…Conservative treatment for at least 1 eye is possible for most bilateral disease. Treatment includes cryotherapy, [6][7][8] either alone or combined with chemotherapy. Long-term follow-up and early counseling about the risk of second primary tumours and transmission should be offered to parents of patients with retinoblastoma.…”

Section: Introductionmentioning

confidence: 99%

Frequency of Retinoblastoma at Lady Reading Hospital, Peshawar, Pakistan

Iqbal

Saeed

1970

Asian JO

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Aim: To ascertain the demographics, clinical features, and treatment options for children with retinoblastoma. Methods: This was a hospital-based cohort study of all children with retinoblastoma presenting from 1 January 2008 to 31 December 2008. Demographic data, presenting features, family history, and findings identified during examination were recorded for each patient. The tumours were classified using the Reese- Ellsworth classification system. Documentation of the tumours included examination under anesthesia, ultrasound B- scan, and computed tomography scan as well as histopathological reporting of enucleated eyes.Results: Twenty seven new patients with retinoblastoma were identified and 36 eyes were affected, with a bilaterality rate of 33%. The frequency was 4.1, with a bimodal peak of presentation of younger than 1 yearand 4 years. The mean age at diagnosis was 3.2 years (SD, 2.5 years; range, 3 months to 8 years). Most of the patients were boys, (59%) and most were in the age range of 1 to 5 years (66%). There was a male preponderance (5:1) amongst patients younger than 1 year and the male to female ratio was equal (1:1) in the 1 to 5 years age range. Leukocoria was the main presentation in 38% of eyes and 19% presented with proptosis. Enucleation/exenteration was performed for 17 unilateral eyes (94%) and 5 bilateral eyes (27%) with group V disease. Groups I and II tumours (n = 1 and n = 7 for unilateral and bilateral eyes, respectively) were treated conservatively with cryotherapy or chemotherapy alone or in combination. The commonest treatment for bilateral disease was enucleation of 1 eye and chemotherapy for the fellow eye (22%). Radiotherapy was advised for patients with histopathological evidence of optic nerve involvement (25%).Conclusions: Retinoblastoma usually affects infants and children younger than 5 years, with no sexual or racial predilection. One-third of patients demonstrate bilaterality, with leukocoria as the commonest presenting feature and proptosis as a feature of late presentation. In bilateral retinoblastoma, primary enucleation of one eye with conservative chemotherapy and/or cryotherapy of the fellow eye is advocated.

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“…Cryotherapy is ideally suited for the treatment of small anterior tumors (Ellsworth 1969;Shields et al 1989;Tolentino and Tablante 1972). Cryotherapy is directly cytotoxic, causing cell lysis by disruption of the cell membrane that occurs after the formation of cytoplasmic ice crystals.…”

Section: Focal Therapiesmentioning

confidence: 99%

Retinoblastoma

2010

Pediatric Oncology

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Cryotherapy of Retinoblastoma

Cited by 24 publications

References 4 publications

Retinoblastoma: A Three-Year-Study at a Brazilian Medical School Hospital

Retinoblastoma: A Three-Year-Study at a Brazilian Medical School Hospital

Frequency of Retinoblastoma at Lady Reading Hospital, Peshawar, Pakistan

Retinoblastoma

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