Treatment of overt extraocular retinoblastoma

Chantada, Guillermo; Fandiño, Adriana; Casak, Sandra J.; Manzitti, Julio; Raslawski, Elsa; Schvartzman, Enrique

doi:10.1002/mpo.10249

Cited by 119 publications

(65 citation statements)

References 13 publications

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“…[3][4][5][6] Results from the most recent Latin-American series reporting patients treated with conventional chemo-and radiotherapy regimens were discouraging with survival figures from 0 to 20%. 3,7,8 Only occasional patients with distant metastatic disease survived and the few survivors reported with conventional chemotherapy included those who had metastasis limited to the lymph nodes, 9 which are now considered as regionally disseminated rather than a distant metastatic site. 10 High-dose chemotherapy followed by ASCR was not available in our setting until recently and, to our knowledge, there are no reported results of this treatment modality for retinoblastoma from less developed countries.…”

Section: Introductionmentioning

confidence: 99%

Successful treatment of metastatic retinoblastoma with high-dose chemotherapy and autologous stem cell rescue in South America

Palma

Sasso

Dufort

et al. 2011

Bone Marrow Transplant

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High-dose chemotherapy (HDC) followed by autologous stem cell rescue (ASCR) is the only curative treatment for metastatic retinoblastoma, but its feasibility in developing countries is unknown. We report 11 consecutive children (six unilateral) treated in three South-American middleincome countries with HDC-ASCR. One patient had metastatic retinoblastoma at diagnosis and the remaining ones had a metastatic relapse. Metastatic sites included BM ¼ 6, bone ¼ 4, orbit ¼ 5 and central nervous system (CNS) ¼ 4. All patients received induction with conventional chemotherapy achieving CR at a median of 5.7 months from the diagnosis of metastasis. Conditioning regimens included carboplatin and etoposide with thiotepa in six or with CY in four or melphalan in one patient. All patients engrafted after G-CSF-mobilized peripheral blood ASCR and no toxic deaths occurred. Two children received post-ASCR CNS radiotherapy. Seven children have disease-free survival (median follow-up 39 months). CNS relapse, isolated (n ¼ 3) or with systemic relapse (n ¼ 1), occurring at a median of 7 months after ASCT was the most common event. In the same period, five children with metastatic retinoblastoma did not qualify for HDC-ASCR and died. We conclude that HDC-ASCR is a feasible and effective treatment for children with metastatic retinoblastoma in middle-income countries.

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Section: Introductionmentioning

confidence: 99%

Successful treatment of metastatic retinoblastoma with high-dose chemotherapy and autologous stem cell rescue in South America

Palma

Sasso

Dufort

et al. 2011

Bone Marrow Transplant

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“…Etoposide therapy is associated with risk for acute myelocytic leukaemia, 12 and secondary leukaemias have so far been reported in two RB patients treated with etoposide. 13,14 Carboplatin may also act synergistically with etoposide in the induction of secondary leukaemias. 15,16 Because these agents are mutagenic, both of these drugs have potential to exacerbate second tumour risk in children with heritable disease.…”

Section: Introductionmentioning

confidence: 99%

Beta-lapachone inhibits proliferation and induces apoptosis in retinoblastoma cell lines

Shah

Conway

Quill

et al. 2007

Eye

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Aims To investigate the cytotoxicity of beta-lapachone, a potent agent that may selectively target tumour cells, in retinoblastoma (RB) cell lines. Methods Growth inhibitory effects of betalapachone were evaluated in Y79, WERI-RB1, and RBM human retinoblastoma cell lines. Pro-apoptotic effects of beta-lapachone were evaluated in Y79 cells by detection of caspase 3/7 activity, by enzyme-linked immunosorbent assay for nucleosome fragments, and by cellular morphological analysis. Results Beta-lapachone induced significant dose-dependent growth inhibitory effects in all three retinoblastoma cell lines. The 50% growth inhibitory concentration (IC 50 ) of this agent was 1.9 lM in Y79 cells, 1.3 lM in WERI-RB1 cells, and 0.9 lM in RBM cells. Beta-lapachone also induced proapoptotic effects in RB cells. Treatment of Y79 cells with 1.9 lM beta-lapachone (IC 50 ) resulted in a peak, fourfold induction of caspase 3/7 activity at 72 h post-treatment; a peak, 5.6-fold increase in nucleosome fragments at 96 h posttreatment; and a peak, 1.7-fold increase in the frequency of apoptotic cells at 48 h posttreatment, relative to vehicle-treated controls. Conclusion Beta-lapachone induced potent cytotoxic effects in RB cell lines at low micromolar concentrations, suggesting this agent could be useful in the clinical management of RB.

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“…[18] Similar results have also been obtained using initial neoadjuvant chemotherapy followed by limited surgery (enucleation or resection of residual orbital mass) and adjuvant therapy and radiotherapy. [19] Comparable results have been reported using HDT with ASCT. Thus, HDT in these two situations seems to be a therapeutic alternative with the advantage of shorter duration of therapy.…”

Section: Chemotherapy For Retinoblastoma Post-enucleation (Chemoprevementioning

confidence: 78%

Genetics and management of retinoblastoma

Bakhshi

2007

J Indian Assoc Pediatr Surg

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Retinoblastoma is the most common intraocular tumor in childhood. In majority of early stage retinoblastoma, the eyeballs as well as vision can be preserved with chemotherapy and local intraocular therapy with laser or photocoagulation. However, more than half the patients in India and other developing nations present in advanced stage of the disease. This article reviews the genetics, clinical approach, and treatment options for retinoblastoma focussing on advances in chemotherapy for intraocular retinoblastoma (chemoreduction), as well as improvement in survival in advanced retinoblastoma with surgery, chemotherapy, radiotherapy, and bone marrow transplantation.

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Treatment of overt extraocular retinoblastoma

Abstract: This treatment strategy was highly efficacious for patients with orbital and/or lymph node extension. Orbital exenteration is not necessary for these patients. Those patients with distant metastatic or CNS disease were not curable with this approach.

Cited by 119 publications

References 13 publications

Successful treatment of metastatic retinoblastoma with high-dose chemotherapy and autologous stem cell rescue in South America

Successful treatment of metastatic retinoblastoma with high-dose chemotherapy and autologous stem cell rescue in South America

Beta-lapachone inhibits proliferation and induces apoptosis in retinoblastoma cell lines

Genetics and management of retinoblastoma

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