Focal periocular carboplatin chemotherapy avoids systemic chemotherapy for unilateral, progressive retinoblastoma.

Abstract

PURPOSE:

The purpose of this study was to report a case of a boy with unilateral, multifocal retinoblastoma who was successfully treated with periocular carboplatin injections for a tumor that progressed despite focal laser ablation.

METHODS:

This is an interventional case report. A boy with a paternal history of retinoblastoma and in utero identification of an RB1 mutation was monitored beginning at 2 weeks of age. When the patient was 6 months old, the first tumor was detected and treatment with a direct, ablative, large spot-size diode laser was initiated. During a 38-month period of follow-up, the patient received 23 laser treatments and 3 periocular carboplatin injections (20 mg in 2 mL) to treat 3 tumors in 1 eye.

RESULTS:

Initially, diode laser ablation of the tumors produced a favorable involutional response of the tumors, associated with a decrease in size and vascularity. Despite aggressive treatment with 12 consecutive laser treatments for 9.7 months, progressive tumor growth was observed in the superonasal tumor, whereas the other 2 tumors remained quiescent. At that time, a series of three focal periocular injections of carboplatin were administered in combination with continued laser ablation. The tumor regressed with type 4 chorioretinal scarring. No systemic chemotherapy or radiation was required.

CONCLUSION:

This case of unilateral, multifocal retinoblastoma was successfully treated solely with diode laser ablation and rescue periocular injections of carboplatin after the failure of laser alone. A trial of periocular carboplatin with laser may be considered in cases of unilateral retinoblastoma that are resistant to laser ablation therapy alone.

• Authors: Theodore Leng, Colleen M Cebulla, Amy C Schefler, Timothy G Murray
• Journal: Retina (Philadelphia, Pa.) (Retina) Vol. 30 Issue 4 Suppl Pg. S66-8 (Apr 2010) ISSN: 1539-2864 [Electronic] United States
• PMID: 20419851 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antineoplastic Agents
• Retinoblastoma Protein
• Carboplatin

Topics

• Antineoplastic Agents (therapeutic use)
• Carboplatin (therapeutic use)
• Combined Modality Therapy
• Humans
• Infant, Newborn
• Injections
• Laser Coagulation
• Lasers, Semiconductor (therapeutic use)
• Male
• Mutation
• Retinal Neoplasms (drug therapy, genetics, surgery, therapy)
• Retinoblastoma (drug therapy, genetics, surgery, therapy)
• Retinoblastoma Protein (genetics)