Chemoreduction in the Initial Management of Intraocular Retinoblastoma

Shields, Carol L.

doi:10.1001/archopht.1996.01100140530002

Cited by 340 publications

(215 citation statements)

References 37 publications

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“…3 Tumor change following two cycles of chemoreduction has been reported at approximately 35% reduction in basal dimension and 50% reduction in thickness. 9 In this analysis, we found that tumor basal dimension reduction following completed six cycles and consolidation (if any) was 36% for group A, 43% for group B, 67% for group C, and 60% for group D. Tumor thickness reduction following completed six cycles and consolidation (if any) was 57% for group A, 50% for group B, 75% for group C, and 67% for group D. A few cases showed very little change in size following chemoreduction. It has been speculated that minimal response following chemoreduction may be a feature of well-differentiated retinoblastoma.…”

Section: Discussionmentioning

confidence: 99%

“…It has been speculated that minimal response following chemoreduction may be a feature of well-differentiated retinoblastoma. 9,21 Followup of such patients has documented that these poorly responsive tumors remain stable. Unpublished observations from our department have also identified that the presence of intratumoral cysts is a potential sign of tumor (14) 42 (33) 2 (18) 88 (19) differentiation and less dramatic response to chemoreduction.…”

Section: Discussionmentioning

confidence: 99%

“…The eligibility criteria for treatment with chemoreduction 9 were children with intraocular retinoblastoma in whom either eye would ordinarily require enucleation or external beam radiotherapy for cure of the disease based on published indications. 2,11 Patients whose tumor(s) could be properly controlled with focal methods alone (cryotherapy, laser photocoagulation, thermotherapy, plaque radiotherapy) were not eligible for inclusion in the chemoreduction protocol.…”

Section: Methodsmentioning

confidence: 99%

“…This approach offers globe salvage for approximately 85% of eyes classified as Reese-Ellsworth groups I to IV, but it is less successful for group V because globe salvage is achieved in only 47% of eyes. 3 Previous publications on the subject of chemoreduction have addressed various issues, some of which include tumor control with chemotherapy alone, 4,5 tumor control with chemotherapy and focal consolidation, [6][7][8][9][10] and risks for failure with need to resort to enucleation or external beam radiotherapy. 3 Chemotherapy alone has been found to control only 8% of eyes with retinoblastoma in various stages, on account of problems with tumor and related seed progression and recurrence.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Chemoreduction for retinoblastoma. Analysis of tumor control and risks for recurrence in 457 tumors

Shields¹,

Mashayekhi²,

Cater³

et al. 2004

American Journal of Ophthalmology

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118

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Chemoreduction for retinoblastoma. Analysis of tumor control and risks for recurrence in 457 tumors

Shields¹,

Mashayekhi²,

Cater³

et al. 2004

American Journal of Ophthalmology

Self Cite

118

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“…1,2 Numerous conservative treatment modalities have been published: cryoapplication, thermotherapy alone or combined with systemic chemotherapy, plaque radiotherapy, or even exclusive chemotherapy. [3][4][5][6][7][8][9][10][11][12] More recently, periocular, intraarterial, and intravitreal administration of chemotherapy have been used and are still under evaluation. These last modalities were developed during the study period.…”

Section: Introductionmentioning

confidence: 99%

Conservative treatment of retinoblastoma: a prospective phase II randomized trial of neoadjuvant chemotherapy followed by local treatments and chemothermotherapy

Rouic

Aerts

Hajage

et al. 2015

Eye

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Purpose Intraocular retinoblastoma treatments often combine chemotherapy and focal treatments. A first prospective protocol of conservative treatments in our institution showed the efficacy of the use of two courses of chemoreduction with etoposide and carboplatin, followed by chemothermotherapy using carboplatin as a single agent and diode laser. In order to decrease the possible longterm toxicity of chemotherapy due to etoposide, a randomized neoadjuvant phase II protocol was conducted using vincristinecarboplatin vs etoposide-carboplatin. Patients and methods The study was proposed when initial tumor characteristics did not allow front-line local treatments. Patients included in this phase II noncomparative randomized study of neoadjuvant chemotherapy received vincristin-carboplatin (new arm) vs etoposide-carboplatin (our reference arm). They were subsequently treated by local treatments and chemothermotherapy. Primary end point was the need for secondary enucleation or external beam radiotherapy (EBRT) not exceeding 40% at 2 years. Results A total of 65 eyes in 55 children were included in the study (May 2004 to August 2009. Of these, 32 eyes (27 children) were treated in the arm etoposide-carboplatin and 33 eyes (28 children) in the arm vincristin-carboplatin. At 2 years after treatment, 23/33 (69.7%) eyes were treated and salvaged without EBRT or enucleation in the arm vincristin-carboplatin and 26/32 (81.2%) in the arm etoposide-carboplatin. Conclusion Even if the two treatment arms could be considered as sufficiently active according to the study decision rules, neoadjuvant chemotherapy by two cycles of vincristine-carboplatin followed by chemothermotherapy appear to offer less optimal local control than the etoposidecarboplatin combination.

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The Outcome of Chemoreduction Treatment in Patients With Reese-Ellsworth Group V Retinoblastoma

Günduz¹

1998

Arch Ophthalmol

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To determine the outcome of chemoreduction treatment in patients with Reese-Ellsworth group V retinoblastoma. Methods: Prospective analysis of 27 eyes in 22 patients with group V retinoblastoma treated with either 2-or 6-cycle chemoreduction and focal treatment methods (argon laser photocoagulation, transpupillary thermotherapy, cryotherapy, and plaque radiotherapy). The need for external beam irradiation and the eventual globe salvage rate were assessed. Median follow-up was 28 months. Results: There were 16 eyes in the 2-cycle chemoreduction treatment group and 11 eyes in the 6-cycle chemoreduction treatment group. No significant difference was noted between the 2 groups with respect to baseline patient and eye findings. After chemoreduction treatment, external beam irradiation was necessary in 12 (75%) of 16 eyes in the 2-cycle chemoreduction treatment group and in 4 (36%) of 11 eyes in the 6-cycle chemoreduction treatment group. There was no statistical difference between the 2-and 6-cycle chemoreduction treatment groups with respect to necessity for external beam

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Chemoreduction in the Initial Management of Intraocular Retinoblastoma

Cited by 340 publications

References 37 publications

Chemoreduction for retinoblastoma. Analysis of tumor control and risks for recurrence in 457 tumors

Chemoreduction for retinoblastoma. Analysis of tumor control and risks for recurrence in 457 tumors

Conservative treatment of retinoblastoma: a prospective phase II randomized trial of neoadjuvant chemotherapy followed by local treatments and chemothermotherapy

The Outcome of Chemoreduction Treatment in Patients With Reese-Ellsworth Group V Retinoblastoma

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