Outcomes of a two-drug chemotherapy regimen for intraocular retinoblastoma

Peter E. Zage, Aaron J. Reitman, Roopa Seshadri, Joanna Lynn Weinstein, Marilyn B Mets, Janice Lasky, Mark J. Greenwald, Lewis C. Strauss, Stewart Goldman*

*Corresponding author for this work

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background. Retinoblastoma is the most common intraocular tumor of childhood. Vision salvage rates in advanced cases are less than ideal, and the optimal treatment for intraocular retinoblastoma has not been established. We report the results of an institutional retinoblastoma treatment trial to determine the vision salvage rates and toxicity of a regimen combining carboplatin and etoposide with focal retinal therapy. Procedure. Twenty-nine patients diagnosed with retinoblastoma in 48 eyes were treated between 1992 and 2004 with at least six cycles of carboplatin and etoposide combined with focal retinal therapy. Results. The response rate of eyes after six cycles of chemotherapy was 85.4%. Twenty-two eyes were enucleated, but only seven eyes received EBRT. The vision salvage rate without EBRT was 82.6% for eyes with Reese-Ellsworth (R-E) groups I-IV tumors and 20% for eyes with R-E group V tumors. The vision salvage rate without EBRT for eyes with Murphree groups A and B tumors was 77.3% but was only 26.9% for eyes with groups C and D tumors. Acute side effects were minimal. Conclusions. The combination of carboplatin and etoposide with focal therapy is a well-tolerated regimen that has acceptable vision salvage rates for R-E groups I-IV and Murphree groups A and B retinoblastoma. This combination avoids the use of EBRT and the toxicity of additional chemotherapy agents. However, patients with R-E group V and Murphree groups C and D retinoblastoma have poorer outcomes and require more intensive therapy.

Original languageEnglish (US)
Pages (from-to)567-572
Number of pages6
JournalPediatric Blood and Cancer
Volume50
Issue number3
DOIs
StatePublished - Mar 1 2008

Fingerprint

Retinoblastoma
Drug Therapy
Pharmaceutical Preparations
Carboplatin
Etoposide
Neoplasms
Therapeutics

Keywords

  • Chemoreduction
  • Retinoblastoma

ASJC Scopus subject areas

  • Cancer Research
  • Pediatrics, Perinatology, and Child Health
  • Hematology

Cite this

Zage, Peter E. ; Reitman, Aaron J. ; Seshadri, Roopa ; Weinstein, Joanna Lynn ; Mets, Marilyn B ; Lasky, Janice ; Greenwald, Mark J. ; Strauss, Lewis C. ; Goldman, Stewart. / Outcomes of a two-drug chemotherapy regimen for intraocular retinoblastoma. In: Pediatric Blood and Cancer. 2008 ; Vol. 50, No. 3. pp. 567-572.
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title = "Outcomes of a two-drug chemotherapy regimen for intraocular retinoblastoma",
abstract = "Background. Retinoblastoma is the most common intraocular tumor of childhood. Vision salvage rates in advanced cases are less than ideal, and the optimal treatment for intraocular retinoblastoma has not been established. We report the results of an institutional retinoblastoma treatment trial to determine the vision salvage rates and toxicity of a regimen combining carboplatin and etoposide with focal retinal therapy. Procedure. Twenty-nine patients diagnosed with retinoblastoma in 48 eyes were treated between 1992 and 2004 with at least six cycles of carboplatin and etoposide combined with focal retinal therapy. Results. The response rate of eyes after six cycles of chemotherapy was 85.4{\%}. Twenty-two eyes were enucleated, but only seven eyes received EBRT. The vision salvage rate without EBRT was 82.6{\%} for eyes with Reese-Ellsworth (R-E) groups I-IV tumors and 20{\%} for eyes with R-E group V tumors. The vision salvage rate without EBRT for eyes with Murphree groups A and B tumors was 77.3{\%} but was only 26.9{\%} for eyes with groups C and D tumors. Acute side effects were minimal. Conclusions. The combination of carboplatin and etoposide with focal therapy is a well-tolerated regimen that has acceptable vision salvage rates for R-E groups I-IV and Murphree groups A and B retinoblastoma. This combination avoids the use of EBRT and the toxicity of additional chemotherapy agents. However, patients with R-E group V and Murphree groups C and D retinoblastoma have poorer outcomes and require more intensive therapy.",
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Outcomes of a two-drug chemotherapy regimen for intraocular retinoblastoma. / Zage, Peter E.; Reitman, Aaron J.; Seshadri, Roopa; Weinstein, Joanna Lynn; Mets, Marilyn B; Lasky, Janice; Greenwald, Mark J.; Strauss, Lewis C.; Goldman, Stewart.

In: Pediatric Blood and Cancer, Vol. 50, No. 3, 01.03.2008, p. 567-572.

Research output: Contribution to journalArticle

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T1 - Outcomes of a two-drug chemotherapy regimen for intraocular retinoblastoma

AU - Zage, Peter E.

AU - Reitman, Aaron J.

AU - Seshadri, Roopa

AU - Weinstein, Joanna Lynn

AU - Mets, Marilyn B

AU - Lasky, Janice

AU - Greenwald, Mark J.

AU - Strauss, Lewis C.

AU - Goldman, Stewart

PY - 2008/3/1

Y1 - 2008/3/1

N2 - Background. Retinoblastoma is the most common intraocular tumor of childhood. Vision salvage rates in advanced cases are less than ideal, and the optimal treatment for intraocular retinoblastoma has not been established. We report the results of an institutional retinoblastoma treatment trial to determine the vision salvage rates and toxicity of a regimen combining carboplatin and etoposide with focal retinal therapy. Procedure. Twenty-nine patients diagnosed with retinoblastoma in 48 eyes were treated between 1992 and 2004 with at least six cycles of carboplatin and etoposide combined with focal retinal therapy. Results. The response rate of eyes after six cycles of chemotherapy was 85.4%. Twenty-two eyes were enucleated, but only seven eyes received EBRT. The vision salvage rate without EBRT was 82.6% for eyes with Reese-Ellsworth (R-E) groups I-IV tumors and 20% for eyes with R-E group V tumors. The vision salvage rate without EBRT for eyes with Murphree groups A and B tumors was 77.3% but was only 26.9% for eyes with groups C and D tumors. Acute side effects were minimal. Conclusions. The combination of carboplatin and etoposide with focal therapy is a well-tolerated regimen that has acceptable vision salvage rates for R-E groups I-IV and Murphree groups A and B retinoblastoma. This combination avoids the use of EBRT and the toxicity of additional chemotherapy agents. However, patients with R-E group V and Murphree groups C and D retinoblastoma have poorer outcomes and require more intensive therapy.

AB - Background. Retinoblastoma is the most common intraocular tumor of childhood. Vision salvage rates in advanced cases are less than ideal, and the optimal treatment for intraocular retinoblastoma has not been established. We report the results of an institutional retinoblastoma treatment trial to determine the vision salvage rates and toxicity of a regimen combining carboplatin and etoposide with focal retinal therapy. Procedure. Twenty-nine patients diagnosed with retinoblastoma in 48 eyes were treated between 1992 and 2004 with at least six cycles of carboplatin and etoposide combined with focal retinal therapy. Results. The response rate of eyes after six cycles of chemotherapy was 85.4%. Twenty-two eyes were enucleated, but only seven eyes received EBRT. The vision salvage rate without EBRT was 82.6% for eyes with Reese-Ellsworth (R-E) groups I-IV tumors and 20% for eyes with R-E group V tumors. The vision salvage rate without EBRT for eyes with Murphree groups A and B tumors was 77.3% but was only 26.9% for eyes with groups C and D tumors. Acute side effects were minimal. Conclusions. The combination of carboplatin and etoposide with focal therapy is a well-tolerated regimen that has acceptable vision salvage rates for R-E groups I-IV and Murphree groups A and B retinoblastoma. This combination avoids the use of EBRT and the toxicity of additional chemotherapy agents. However, patients with R-E group V and Murphree groups C and D retinoblastoma have poorer outcomes and require more intensive therapy.

KW - Chemoreduction

KW - Retinoblastoma

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DO - 10.1002/pbc.21301

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