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Researchers explain technique for good control of retinoblastoma tumors
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Neoadjuvant chemotherapy followed by conservative ocular therapy and chemothermotherapy can provide good tumor control with little need for external beam radiotherapy for children with retinoblastoma, a prospective, multicenter study found.
Livia Lumbroso-Le Rouic, MD, and colleagues administered neoadjuvant chemotherapy with two cycles of carboplatin and etoposide followed by a number of conservative ocular therapies and chemothermotherapy; 115 eyes of 83 children with retinoblastoma were studied. Of these children, 19 (22.8%) had unilateral lesions and 64 (77.1%) had bilateral lesions. Subsequently, the investigators evaluated tumor control and determined whether the conservative management regimen decreased indications for external beam radiotherapy.
A total of 89 eyes of 66 children received neoadjuvant chemotherapy before ocular therapy.
Ocular therapy consisted of one or a combination of several techniques: 86 eyes of 65 children received chemothermotherapy with an average of three cycles per child; 24 eyes of 22 children received thermotherapy alone; 58 eyes of 49 children received cryoapplication; and 29 eyes of 26 children received iodine-125 brachytherapy.
After a median follow-up of 51 months, tumor control was achieved in 97 eyes (84.3%), the authors reported.
At final follow-up, external beam radiotherapy was used in 13 eyes of nine children (12%). Twenty-three eyes (20%) were enucleated; five of these enucleations were because of complications even though tumor control was obtained.
"The cumulative doses of chemotherapy used for the majority of patients were lower than those reported in most other publications, and the safety was excellent," the study authors said in the August issue of Ophthalmology.