Experience with chemoreduction and focal therapy for intraocular retinoblastoma

CHANTADA GL, FANDIÑO AC, RASLAWSKI EC, MANZITTI J, DE DÁVILA MT, CASAK SJ,

MEDICAL AND PEDIATRIC ONCOLOGY

Año: 2005 p. 455 - 460

0098-1532

BACKGROUND: Chemoreduction is used for the treatment of retinoblastoma inindustrialized nations; however, there are fewer data from developing countries. Before the implementation of this program, radiotherapy was used in almost allpreserved eyes. METHODS: Retrospective evaluation from 1995 to 2001 at theHospital Garrahan (Argentina). Carboplatin 18.7 mg/kg/day 1 and vincristine (0.05mg/kg/day 1) were offered to patients with Reese-Ellsworth (RE) groups I-III and all unilateral cases. Etoposide (3.3 mg/kg/day 1 and 2) was added for groups IVand V. The number of cycles was tailored according to response. RESULTS:Fifty-eight patients (78 eyes) were evaluated (39 bilateral, 19 unilateral). Witha median follow-up of 47 months, 40 patients had unilateral enucleation, 14 were not enucleated, and 4 had bilateral enucleation. Nineteen patients had unilateralinitial enucleation. Eye preservation at 5 years was: RE groups I-III (n = 24eyes), 0.9 (SE: 0.095) IV-V (n = 54), 0.45 (SE 0.07). Patients received a median of four cycles of chemotherapy. Acute toxicity was mild. External beamradiotherapy was avoided in 41% of eyes with groups I-III. Etoposide was avoided in 24 patients. Two patients died of metastasis. No secondary malignancyoccurred. CONCLUSIONS: Compared to our previous experience, eye preservation was better and even though less radiotherapy was used, it was prescribed more oftenthan currently recommended in eyes with less advanced disease because of limited availability of sophisticated local therapy.