Chemoreduction for Retinoblastoma: Analysis of Tumor Control and Risks for Recurrence in 457 Tumors

Overview

Journal Trans Am Ophthalmol Soc

Specialty Ophthalmology

Date 2005 Mar 8

PMID 15747743

Citations 14

Authors

Carol L Shields

Arman Mashayekhi

Jacqueline Cater

Abdallah Shelil

Anna T Meadows

Jerry A Shields

Affiliations

Soon will be listed here.

Abstract

Purpose: To evaluate individual tumor control following chemoreduction for retinoblastoma.

Methods: Prospective nonrandomized single-center case series of 457 retinoblastomas managed with six cycles of chemoreduction (vincristine, etoposide, and carboplatin). The tumors were then managed with chemoreduction alone (group A) or chemoreduction combined with thermotherapy (group B), cryotherapy (group C), or both thermotherapy and cryotherapy (group D). The main outcome measure was development of tumor recurrence.

Results: Of 457 retinoblastomas, 63 (14%) were in group A, 256 (56%) in group B, 127 (28%) in group C, and 11 (2%) in group D. The tumor was located in the macula in 33 (52%) of group A, 109 (43%) of group B, 3 (2%) of group C, and 1 (9%) of group D. Using Kaplan-Meier analysis, recurrence of the individual retinoblastoma at 7 years was found in 45% of group A and in 18% of combined groups B, C, and D. Treatment of the 93 tumor recurrences included thermotherapy, cryotherapy, or plaque radiotherapy in 62 cases (67%) and external beam radiotherapy or enucleation in 31 cases (33%). Risk factors predictive of tumor recurrence by multivariate analysis included macular tumor location for all groups and, additionally, female sex for group A and increasing tumor thickness for groups B, C, and D.

Conclusions: Chemoreduction alone or combined with cryotherapy and/or thermotherapy is effective for treatment of retinoblastoma, but tumor recurrence is greatest for those located in the macula and those with greater thickness. Globe salvage is usually achieved despite tumor recurrence.

Citing Articles

Nanoparticle-based delivery systems as emerging therapy in retinoblastoma: recent advances, challenges and prospects.

Onugwu A, Ugorji O, Ufondu C, Ihim S, Echezona A, Nwagwu C Nanoscale Adv. 2023; 5(18):4628-4648.

PMID: 37705787 PMC: 10496918. DOI: 10.1039/d3na00462g.

Primary Macular Retinoblastoma: Clinical Presentation and Treatment Outcomes.

Chandra K, Raval V, Reddy P V, Kaliki S J Vitreoretin Dis. 2023; 6(5):367-373.

PMID: 37006899 PMC: 9954921. DOI: 10.1177/24741264221107757.

Selective Induction of Intrinsic Apoptosis in Retinoblastoma Cells by Novel Cationic Antimicrobial Dodecapeptides.

Babu V, Kizhakeyil A, Dudeja G, Chaurasia S, Barathi V, Heymans S Pharmaceutics. 2022; 14(11).

PMID: 36432697 PMC: 9694048. DOI: 10.3390/pharmaceutics14112507.

Response criteria for intraocular retinoblastoma: RB-RECIST.

Berry J, Munier F, Gallie B, Polski A, Shah S, Shields C Pediatr Blood Cancer. 2021; 68(5):e28964.

PMID: 33624399 PMC: 8049511. DOI: 10.1002/pbc.28964.

Treatment Outcomes of Focal Laser Consolidation during Chemoreduction for Group B Retinoblastoma.

Kim J, Aziz H, McGovern K, Zolfaghari E, Jubran R, Murphree A Ophthalmol Retina. 2019; 1(5):361-368.

PMID: 31047562 PMC: 7448755. DOI: 10.1016/j.oret.2017.01.014.

References

Friedman D, Himelstein B, Shields C, Shields J, Needle M, Miller D . Chemoreduction and local ophthalmic therapy for intraocular retinoblastoma. J Clin Oncol. 2000; 18(1):12-7. DOI: 10.1200/JCO.2000.18.1.12. View

Wilson M, Rodriguez-Galindo C, Haik B, Moshfeghi D, Merchant T, Pratt C . Multiagent chemotherapy as neoadjuvant treatment for multifocal intraocular retinoblastoma. Ophthalmology. 2001; 108(11):2106-14; discussion 2114-5. DOI: 10.1016/s0161-6420(01)00805-3. View

Gombos D, Kelly A, Coen P, Kingston J, Hungerford J . Retinoblastoma treated with primary chemotherapy alone: the significance of tumour size, location, and age. Br J Ophthalmol. 2002; 86(1):80-3. PMC: 1770955. DOI: 10.1136/bjo.86.1.80. View

Singh A, Shields C, Shields J . Lack of response to chemoreduction in presumed well differentiated retinoblastoma. J Pediatr Ophthalmol Strabismus. 2002; 39(2):107-9. DOI: 10.3928/0191-3913-20020301-11. View

Shields C, Honavar S, Shields J, Demirci H, Meadows A, Naduvilath T . Factors predictive of recurrence of retinal tumors, vitreous seeds, and subretinal seeds following chemoreduction for retinoblastoma. Arch Ophthalmol. 2002; 120(4):460-4. View

Shields C, Honavar S, Meadows A, Shields J, Demirci H, Singh A . Chemoreduction plus focal therapy for retinoblastoma: factors predictive of need for treatment with external beam radiotherapy or enucleation. Am J Ophthalmol. 2002; 133(5):657-64. DOI: 10.1016/s0002-9394(02)01348-x. View

Shields C, Shields J . Editorial: chemotherapy for retinoblastoma. Med Pediatr Oncol. 2002; 38(6):377-8. DOI: 10.1002/mpo.1353. View

Lumbroso L, Doz F, Urbieta M, Levy C, Bours D, Asselain B . Chemothermotherapy in the management of retinoblastoma. Ophthalmology. 2002; 109(6):1130-6. DOI: 10.1016/s0161-6420(02)01053-9. View

Epstein J, Shields C, Shields J . Trends in the management of retinoblastoma: evaluation of 1,196 consecutive eyes during 1974 to 2001. J Pediatr Ophthalmol Strabismus. 2003; 40(4):196-203; quiz 217-8. DOI: 10.3928/0191-3913-20030701-05. View

10.

Lee T, Hayashi N, Dunkel I, Beaverson K, Novetsky D, Abramson D . New retinoblastoma tumor formation in children initially treated with systemic carboplatin. Ophthalmology. 2003; 110(10):1989-94. DOI: 10.1016/S0161-6420(03)00669-9. View

11.

Shields C, Shelil A, Cater J, Meadows A, Shields J . Development of new retinoblastomas after 6 cycles of chemoreduction for retinoblastoma in 162 eyes of 106 consecutive patients. Arch Ophthalmol. 2003; 121(11):1571-6. DOI: 10.1001/archopht.121.11.1571. View

12.

Shields J, Parsons H, Shields C, Giblin M . The role of cryotherapy in the management of retinoblastoma. Am J Ophthalmol. 1989; 108(3):260-4. DOI: 10.1016/0002-9394(89)90116-5. View

13.

Gallie B, Budning A, DeBoer G, Thiessen J, Koren G, Verjee Z . Chemotherapy with focal therapy can cure intraocular retinoblastoma without radiotherapy. Arch Ophthalmol. 1996; 114(11):1321-8. DOI: 10.1001/archopht.1996.01100140521001. View

14.

Shields C, De Potter P, Himelstein B, Shields J, Meadows A, Maris J . Chemoreduction in the initial management of intraocular retinoblastoma. Arch Ophthalmol. 1996; 114(11):1330-8. DOI: 10.1001/archopht.1996.01100140530002. View

15.

Kingston J, Hungerford J, Madreperla S, Plowman P . Results of combined chemotherapy and radiotherapy for advanced intraocular retinoblastoma. Arch Ophthalmol. 1996; 114(11):1339-43. DOI: 10.1001/archopht.1996.01100140539004. View

16.

Murphree A, Villablanca J, Deegan 3rd W, Sato J, Malogolowkin M, Fisher A . Chemotherapy plus local treatment in the management of intraocular retinoblastoma. Arch Ophthalmol. 1996; 114(11):1348-56. DOI: 10.1001/archopht.1996.01100140548005. View

17.

Shields C, Shields J, Needle M, De Potter P, Kheterpal S, Hamada A . Combined chemoreduction and adjuvant treatment for intraocular retinoblastoma. Ophthalmology. 1997; 104(12):2101-11. DOI: 10.1016/s0161-6420(97)30053-0. View

18.

Levy C, Doz F, Quintana E, Pacquement H, Michon J, Schlienger P . Role of chemotherapy alone or in combination with hyperthermia in the primary treatment of intraocular retinoblastoma: preliminary results. Br J Ophthalmol. 1999; 82(10):1154-8. PMC: 1722363. DOI: 10.1136/bjo.82.10.1154. View

19.

Shields C, Shields J . Recent developments in the management of retinoblastoma. J Pediatr Ophthalmol Strabismus. 1999; 36(1):8-18; quiz 35-6. DOI: 10.3928/0191-3913-19990101-04. View

20.

Shields C, Santos M, Diniz W, Gunduz K, Mercado G, Cater J . Thermotherapy for retinoblastoma. Arch Ophthalmol. 1999; 117(7):885-93. DOI: 10.1001/archopht.117.7.885. View