Chemothermotherapy in the management of retinoblastoma1 1None of the authors have any financial interests in the drugs or devices described in this article.

Lumbroso, Livia; Doz, François; Urbieta, M.; Lévy, Christine; Bours, D.; Asselain, Bernard; Vedrenne, J; Zucker, Jean‐Michel; Desjardins, Laurence

doi:10.1016/s0161-6420(02)01053-9

Cited by 67 publications

(15 citation statements)

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“…12,13,26 However, our median laser power was higher, while the median treatment duration was shorter than those in other studies worldwide. 13,23,31 This may be because we only included early-stage tumors, while some authors selected tumors at all stages. In addition, we used slightly higher energies and thus reduced the treatment duration.…”

Section: Discussioncontrasting

confidence: 74%

Conservative treatment using laser diode and systemic chemotherapy for early‐stage bilateral retinoblastoma: A 14‐year prospective cohort study

Phan,

Derumigny,

Duong

et al. 2023

Cancer Reports

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BackgroundSolid evidence of the safety and effectiveness of retinoblastoma (RB) conservative treatment using thermotherapy and systemic chemotherapy with long‐term follow‐up is scarce, especially in low‐resource countries.AimsThis study examined the outcomes of this treatment and associated predictors in Vietnam to strengthen the current RB treatment protocol focusing on preserving eye and vision in low‐resource settings.Methods and resultsA prospective cohort study was conducted at Ho Chi Minh City Eye Hospital in Vietnam from 2005 to 2019. All eligible patients with bilateral RB (one eye already removed and another eye classified as group A or B) and without previous treatment were recruited. All patients received thermotherapy and six cycles of systemic three‐agent chemotherapy repeated every 4 weeks. A standardized questionnaire was used to collect information on study participants' age, symptoms, tumor characteristics, treatment, and outcomes. Among 50 eyes of all 50 patients with a median age of 9 (4–20) months, 34 eyes were in group B (68%). The median follow‐up time was 60 (60–84) months. All 139 preserved tumors regressed mostly to type 4 (70.4%) and type 3 (23.7%) scars. Kaplan–Meier analysis found the overall globe‐salvage rate at 5 years of 91.9% (95% CI: 80.1%–97.7%). Most eyes (41/50, 82%, 95% CI: 69.2%–90.2%) had a final visual acuity ≥0.1. The visual acuity is higher when tumors regressed to a type 4 scar (p = .007, AOR = 8.098, 95% CI: 1.79–36.53) which also shows less enucleation than a type 3 scar (p = .002, AOR = 0.06, 95% CI: 0.01–0.37%). Gender effect on visual acuity after treatment was significant and may be due to discrimination. No major complications were recorded.ConclusionConservative treatment of early‐stage RB is safe and effective. Long‐term, thorough follow‐ups of patients post‐treatment are needed. The regression patterns of scars could be a useful indicator of treatment failure.

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Section: Discussioncontrasting

confidence: 74%

Conservative treatment using laser diode and systemic chemotherapy for early‐stage bilateral retinoblastoma: A 14‐year prospective cohort study

Phan,

Derumigny,

Duong

et al. 2023

Cancer Reports

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“…As retinoblastoma primary tumors start from a solid intraretinal growth, chemotherapy is often clinically used in combination with focal thermotherapy. Clinical chemothermotherapy protocols consist of systemic carboplatin treatment followed by laser irradiation for a duration of several minutes, typically 1–16 min 12,41 . In contrast, studies investigating drug candidates for their synergy with heat reproduce hyperthermia conditions in vitro by incubating treated cells at stable elevated temperatures for typically 1–2 h 42,43 .…”

Section: Resultsmentioning

confidence: 99%

“…Intravenous and intra‐arterial chemotherapy are typically used as a first‐line or salvage treatment for retinal and subretinal disease, while intraocular injections are necessary to manage intravitreal and/or aqueous seeding 8–10 . Thermotherapy can be used isolated for small retinal or subretinal tumor or tumor relapses or combined with systemic chemotherapy (chemothermotherapy) 11–13 …”

Section: Introductionmentioning

confidence: 99%

“…[8][9][10] Thermotherapy can be used isolated for small retinal or subretinal tumor or tumor relapses or combined with systemic chemotherapy (chemothermotherapy). [11][12][13] Systemic chemotherapeutic agents currently used to treat retinoblastoma, such as carboplatin, etoposide, and vincristine, were not specifically developed for this disease or identified through a systematic screening approach, but rather chosen through pilot studies based on their performance in other pediatric cancers. 14 In contrast, melphalan was found to be the most tumoricidal drug among 12 other drugs in vitro and is used exclusively for targeted chemotherapy (intra-arterial or intraocular injections) due to its high systemic toxicity.…”

Section: Introductionmentioning

confidence: 99%

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Translational screening platform to evaluate chemotherapy in combination with focal therapy for retinoblastoma

et al. 2023

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Retinoblastoma is the most common pediatric eye cancer. It is currently treated with a limited number of drugs, adapted from other pediatric cancer treatments. Drug toxicity and relapse of the disease warrant new therapeutic strategies for these young patients. In this study, we developed a robust tumoroid‐based platform to test chemotherapeutic agents in combination with focal therapy (thermotherapy) – a treatment option widely used in clinical practice – in accordance with clinically relevant trial protocols. The model consists of matrix‐embedded tumoroids that retain retinoblastoma features and respond to repeated chemotherapeutic drug exposure similarly to advanced clinical cases. Moreover, the screening platform includes a diode laser (810 nm, 0.3 W) to selectively heat the tumoroids, combined with an on‐line system to monitor the intratumoral and surrounding temperatures. This allows the reproduction of the clinical settings of thermotherapy and combined chemothermotherapy treatments. When testing the two main drugs currently used in clinics to treat retinoblastoma in our model, we observed results similar to those clinically obtained, validating the utility of the model. This screening platform is the first system to accurately reproduce clinically relevant treatment methods and should lead to the identification of more efficient drugs to treat retinoblastoma.

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“…Moreover, the neonatal fundus is typically lightly pigmented and thus transpupillary thermotherapy may not produce enough heat to kill a small focus that in an older child would be eradicated [Figure 3]. These tumors, some of which may still be lower grade lesions more akin to retinocytomas, consequently may need chemothermotherapy[3536] or a radioactive plaque to be controlled. The preliminary experience in the Retinoblastoma Referral Service of Sienna suggests that ophthalmic artery chemosurgery may be more efficient in destroying such small tumors.…”

Section: Characteristics Of Neonatal Retinoblastomamentioning

confidence: 99%

Neonatal retinoblastoma

Kivelä

Hadjistilianou

2017

Asia-Pacific Journal of Oncology Nursing

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From 7% to 10% of all retinoblastomas and from 44% to 71% of familial retinoblastomas in developed countries are diagnosed in the neonatal period, usually through pre- or post-natal screening prompted by a positive family history and sometimes serendipitously during screening for retinopathy of prematurity or other reasons. In developing countries, neonatal diagnosis of retinoblastoma has been less common. Neonatal retinoblastoma generally develops from a germline mutation of RB1, the retinoblastoma gene, even when the family history is negative and is thus usually hereditary. At least one-half of infants with neonatal retinoblastoma have unilateral tumors when the diagnosis is made, typically the International Intraocular Retinoblastoma Classification (Murphree) Group B or higher, but most germline mutation carriers will progress to bilateral involvement, typically Group A in the fellow eye. Neonatal leukokoria usually leads to the diagnosis in children without a family history of retinoblastoma, and a Group C tumor or higher is typical in the more advanced involved eye. Almost all infants with neonatal retinoblastoma have at least one eye with a tumor in proximity to the foveola, but the macula of the fellow eye is frequently spared. Consequently, loss of reading vision from both eyes is exceptional. A primary ectopic intracranial neuroblastic tumor known as trilateral retinoblastoma is no more common after neonatal than other retinoblastoma. For many reasons, neonatal retinoblastoma may be a challenge to eradicate, and the early age at diagnosis and relatively small tumors do not guarantee the preservation of both eyes of every involved child. Oncology nurses can be instrumental in contributing to better outcomes by ensuring that hereditary retinoblastoma survivors receive genetic counseling, by referring families of survivors to early screening programs when they are planning for a baby, and by providing psychological and practical support for parents when neonatal retinoblastoma has been diagnosed.

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Chemothermotherapy in the management of retinoblastoma1 1None of the authors have any financial interests in the drugs or devices described in this article.

Cited by 67 publications

References 15 publications

Conservative treatment using laser diode and systemic chemotherapy for early‐stage bilateral retinoblastoma: A 14‐year prospective cohort study

Conservative treatment using laser diode and systemic chemotherapy for early‐stage bilateral retinoblastoma: A 14‐year prospective cohort study

Translational screening platform to evaluate chemotherapy in combination with focal therapy for retinoblastoma

Neonatal retinoblastoma

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