Risk of Cataract Extraction Among Adult Retinoblastoma Survivors

Chodick, Gabriel; Kleinerman, Ruth A.; Stovall, Marilyn; Abramson, David H.; Seddon, Johanna M.; Smith, Susan A.; Tucker, Margaret A.

doi:10.1001/archophthalmol.2009.271

Cited by 20 publications

(10 citation statements)

References 33 publications

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“…Because intraocular retinoblastoma has cure rates that approach 100%, and treatment with vincristine, etoposide, and carboplatin is highly successful in patients with Group B intraocular disease, our stopping criteria were particularly stringent. We also did not want an excess number of patients to be exposed to additional chemotherapy or radiotherapy, both of which are associated with significant long‐term toxicities, most particularly, SMN …”

Section: Discussionmentioning

confidence: 99%

“…Enucleation and external beam radiotherapy enabled survival to increase from 30% in the 1930s to almost 100% at the present time in high‐income countries, but this increased survival is accompanied by long‐term morbidity and mortality. Survivors are at risk for visual impairment, cataract, dry eye, midface and orbital deformities, and, most significantly, subsequent neoplasms (SMNs) . In order to avoid these complications, retinoblastoma therapy has undergone a dramatic change during the past two decades, with the introduction of systemic chemotherapy (chemoreduction) together with local ophthalmic therapies and, more recently, regionally administered subtenon and selective intraarterial and intravitreal chemotherapy .…”

Section: Introductionmentioning

confidence: 99%

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Systemic neoadjuvant chemotherapy for Group B intraocular retinoblastoma (ARET0331): A report from the Children's Oncology Group

Friedman

Krailo

Villaluna

et al. 2016

Pediatr Blood Cancer

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Purpose To evaluate a chemoreduction regimen using systemic vincristine and carboplatin and local ophthalmic therapies to avoid external-beam radiotherapy (EBRT) or enucleation in patients with Group B intraocular retinoblastoma. Patients and Methods Twenty-one patients (25 eyes) were treated with 6 cycles of vincristine and carboplatin, accompanied by local ophthalmic therapies after cycle 1. The primary study objective was to determine the 2-year event-free survival (EFS) where an event was defined as the use of systemic chemotherapy in addition to vincristine or carboplatin, EBRT and/or enucleation. Results All patients had tumor regression after the first cycle of vincristine and carboplatin and only two patients had progression during therapy. There were 7 treatment failures within 2.0 years of study enrollment, resulting in 2-year EFS of 65% and early study closure in accordance with the statistical design. The 2-year cumulative incidence of enucleation was 15%; for external beam radiation therapy was 10% and for chemotherapy to control progressive disease was 10%. All patients sustaining a treatment failure were salvaged with additional therapy. Conclusions For the majority of patients with Group B intraocular retinoblastoma, chemoreduction with vincristine and carboplatin, without etoposide, in conjunction with local therapy provides excellent opportunity for ocular salvage. Local therapy given with every chemotherapy cycle and incorporation of etoposide may provide improved ocular salvage rates. Central review of group at diagnosis is critical in assigning appropriate therapies.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Systemic neoadjuvant chemotherapy for Group B intraocular retinoblastoma (ARET0331): A report from the Children's Oncology Group

Friedman

Krailo

Villaluna

et al. 2016

Pediatr Blood Cancer

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“…Patients treated with EBRT need lessintensive follow-up and are likely to be cured with one 6-week course of radiotherapy, whereas children treated with chemoreduction and local therapy usually need a more intensive, longer follow-up to consolidate tumor response and treat later relapses. However, surgery for repairing radiation-induced cataracts that occur in almost all patients within a few years of irradiation should be available [64]. Therefore, the availability of a highquality EBRT facility is a priority in this scenario, especially in setting 2.…”

Section: Treatment Of Bilateral Retinoblastomamentioning

confidence: 99%

SIOP‐PODC recommendations for graduated‐intensity treatment of retinoblastoma in developing countries

Chantada

Luna‐Fineman

Sitorus

et al. 2013

Pediatric Blood & Cancer

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Retinoblastoma remains incurable in many regions of the world. The major obstacles to cure are delayed diagnosis, poor treatment compliance, and lack of evidence‐based recommendations for clinical management. Although enucleation is curative for intraocular disease, in developing countries retinoblastoma is often diagnosed after the disease has disseminated beyond the eye. A SIOP‐PODC committee generated guidelines for the clinical management of retinoblastoma in developing countries and developed a classification system based on the resources available in those settings. Recommendations are provided for staging and treatment of unilateral and bilateral retinoblastoma and counseling of families for whom compliance is an issue. Pediatr Blood Cancer 2013; 60: 719–727. © 2013 Wiley Periodicals, Inc.

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“…Many studies have indicated that after external beam radiation therapy, cataracts can develop after doses as low as 2 Gy (Dynlacht, 2006;Gordon, 1995). For over 100 years, external beam radiation has been used to treat retinoblastoma because in certain cases, it can achieve tumor control and enable retention of vision when other treatment modalities have failed (Chodick et al, 2009). Although other treatment modalities such as chemotherapy and laser are more commonly used for retinoblastoma patients at the present time, external beam radiation is still used as salvage therapy in advanced cases.…”

Section: Epidemiology 211 Incidencementioning

confidence: 99%