Approaches to Treatment for Extraocular Retinoblastoma

Jubran, Rima; Erdreich‐Epstein, Anat; Butturini, Anna; Murphree, A. Linn; Villablanca, Judith G.

doi:10.1097/00043426-200401000-00011

Cited by 85 publications

(68 citation statements)

References 8 publications

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“…This trend can be due to poverty, low socio-economic status, illiteracy, lack of access to tertiary oncology centres thus causing a delay in presentation and, consequently a delay in diagnosis and subsequent treatment. Also a greater number of cases with extra-ocular extension and metastasis are seen in developing countries as compared to developed nations where the incidence is only 2% to 5% (7).…”

Section: Discussionmentioning

confidence: 99%

An extremely rare case of metastatic retinoblastoma of parotids presenting as a massive swelling in a child

Purkayastha¹,

Sharma²,

Pathak³

et al. 2016

Transl. Pediatr.

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Retinoblastoma (Rb) is a common childhood malignancy but bilateral Rb with metastasis to parotids is very uncommon. To the best of our knowledge, bilateral Rb metastasizing to parotids is very rare and this is the fifth such case reported in world literature till date in a 2-year-old male child who underwent exenteration of left eye for bilateral Rb and later developed recurrent metastasis to left parotid requiring parotidectomy. A year later he presented again with swelling left parotid region extending from occipital region reaching upto left anterior chest wall with intra-cranial extension on magnetic resonance imaging.Histopathological examination of the parotid swelling and immunohistochemistry showed metastasis from Rb. He was treated with chemotherapy followed by radiotherapy to local site and brain to which he responded well. Presently on regular follow up without any signs of locoregional and distal metastasis. Till date different types of primary parotid tumors have been reported in literature but a metastatic parotid tumor is extremely rare and therefore this case is being reported to highlight the extreme rarity, the diagnostic and therapeutic challenges, the highly aggressive nature and overall dismal prognosis of this disease entity.

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Section: Discussionmentioning

confidence: 99%

An extremely rare case of metastatic retinoblastoma of parotids presenting as a massive swelling in a child

Purkayastha¹,

Sharma²,

Pathak³

et al. 2016

Transl. Pediatr.

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“…5,14,[16][17][18][19][20] To our knowledge, only two reports included more than 10 patients and they concluded that consolidation with HDC and ASCR provides a chance for cure, estimated to be in the range of 60-70%, especially for children with metastatic disease outside the CNS. 6,15 Despite the fact the results in children with CNS dissemination were poorer, recent reports showed that some children with CNS invasion 14 or with trilateral disease 21 could be cured with this strategy.…”

Section: Discussionmentioning

confidence: 99%

“…These include: the proposed superiority of thiotepacontaining regimens and the use of post transplant radiotherapy to involved bulky sites that could not be addressed by this study and the previous reports. 5,6,[16][17][18]20,26 The current international multi-center trial (COG ARET 0321) will be a key instrument for responding these questions. 27 Metastatic retinoblastoma is now less frequent in South America, 28 probably because of earlier diagnosis.…”

Section: Discussionmentioning

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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“…The overall occurrence of extraocular retinoblastoma was 4.8% of all patients at an institution. 3 Since retinoblastoma is highly chemosensitive, a treatment strategy that includes the dose-escalation of chemotherapeutic agents and stem cell support should be promising. We treated five patients with metastatic retinoblastoma using high-dose chemotherapy (HDC) followed by autologous stem cell transplantation (SCT), and three patients are currently alive and disease-free.…”

mentioning

confidence: 99%

A multidisciplinary treatment strategy that includes high-dose chemotherapy for metastatic retinoblastoma without CNS involvement

Matsubara¹,

Makimoto²,

Higa³

et al. 2005

Bone Marrow Transplant

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Summary:The prognosis of patients with metastatic retinoblastoma is poor with conventional chemotherapy and radiation. Since retinoblastoma is highly chemosensitive, doseescalation of chemotherapeutic agents with stem cell support should be promising. We report our experience with high-dose chemotherapy (HDC) and autologous stem cell transplantation (SCT) in patients with metastatic retinoblastoma. Five patients with metastatic retinoblastoma underwent HDC with autologous SCT following conventional chemotherapy and local radiation therapy. Stem cells (bone marrow in four and peripheral blood stem cells in one) were collected after marrow involvement was cleared. Melphalan was a key drug in all patients, and was administered in combination with other agents such as cisplatin, cyclophosphamide, carboplatin or thiotepa. Three patients are currently alive disease-free at 113, 107 and 38 months, respectively, from the time of SCT. They had no central nervous system (CNS) involvement. The two patients who died of disease had CNS involvement. No long-term sequelae of HDC have been noted. Our treatment strategy using HDC appears to be effective for treating metastatic retinoblastoma without CNS involvement.

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Approaches to Treatment for Extraocular Retinoblastoma

Cited by 85 publications

References 8 publications

An extremely rare case of metastatic retinoblastoma of parotids presenting as a massive swelling in a child

An extremely rare case of metastatic retinoblastoma of parotids presenting as a massive swelling in a child

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

A multidisciplinary treatment strategy that includes high-dose chemotherapy for metastatic retinoblastoma without CNS involvement

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