Korean J Ophthalmol.  2010 Aug;24(4):219-224. 10.3341/kjo.2010.24.4.219.

Eye-Preserving Therapy in Retinoblastoma: Prolonged Primary Chemotherapy Alone or Combined with Local Therapy

• Shin JY
• Kim JH
• Yu YS
• Khwarg SI
• Choung HK
• Shin HY
• Ahn HS

• KMID: 949059
• DOI: http://doi.org/10.3341/kjo.2010.24.4.219

Abstract

PURPOSE
To evaluate the efficacy of primary chemotherapy combined with local therapy in the treatment of retinoblastomas not treatable with a single therapeutic method.
METHODS
We performed a retrospective chart review of 227 patients diagnosed with retinoblastoma. Sixty-five eyes in 52 patients had tumors not treatable with a single therapeutic method and received primary chemotherapy combined with local therapy as needed.
RESULTS
Tumor control and eye salvage was achieved in 34 of the 65 eyes; the probability of ocular survival was 46.56% using the Kaplan-Meier method. Forty-three of the 65 eyes were group D or E tumors, in which tumor control and eye salvage was achieved in 16 eyes. Twenty eyes were treated with chemotherapy only, while 28 eyes received one additional modality of local therapy, and 17 eyes received two modalities of local therapy. Of the eyes treated with chemotherapy only, tumor control was achieved in 5 eyes.
CONCLUSIONS
Primary chemotherapy combined with local therapy can be effective and safe in the treatment of retinoblastomas otherwise untreatable with other therapeutic methods, such as group D and E retinoblastomas. More vigorous treatment with more local therapeutic methods combined may yield even better results.

Keyword

Chemotherapy; Eye preservation; Retinoblastoma

MeSH Terms

Antineoplastic Agents/*therapeutic use
Child, Preschool
Cryotherapy/*methods
Diagnosis, Differential
Female
Follow-Up Studies
Humans
Hyperthermia, Induced/*methods
Infant
Infant, Newborn
Laser Coagulation/*methods
Male
Ophthalmoscopy
Retinal Neoplasms/diagnosis/physiopathology/*therapy
Retinoblastoma/diagnosis/physiopathology/*therapy
Retrospective Studies
Tomography, X-Ray Computed
Treatment Outcome
*Visual Acuity

Figure

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  Fig. 1 Probability of ocular survival using the Kaplan-Meier method.

• 

  Fig. 2 Probability of overall survival using the Kaplan-Meier method.

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