Outcomes of Intravenous Chemotherapy (Chemoreduction) for Retinoblastoma Based on Patient Age in 964 Eyes of 554 Patients.

Abstract

PURPOSE:

To evaluate retinoblastoma control after intravenous chemotherapy (chemoreduction) by patient age at presentation.

DESIGN:

Retrospective case series.

METHODS:

This study included 964 eyes of 554 patients treated with chemoreduction at Ocular Oncology Service at Wills Eye Hospital. Patients received 6 monthly cycles of standard chemoreduction. Additional therapies for tumor control were performed as needed.

RESULTS:

Of 964 eyes, a comparison by age group (<6 months vs. 6-12 months vs. 13-24 months vs. >24 months) revealed more advanced age group with higher frequency of group E tumor (15% vs. 25% vs. 32% vs. 39%, P < 0.001). By treatment outcomes, complete tumor control was achieved with chemoreduction alone more often in less advanced age group (46% vs. 30% vs. 17% vs. 8%, P < 0.001). Additional treatment after chemoreduction was needed more often in more advanced age group with external beam radiotherapy (EBRT; 9% vs. 16% vs. 20% vs. 15%, P = 0.006) or enucleation (12% vs. 18% vs. 26% vs. 37%, P < 0.001). Over time (1994-1998 vs. 1999-2003 vs. 2004-2008 vs. 2009-2013 vs. 2014-2019), the paradigm for additional required treatment after chemoreduction shifted toward less EBRT (27% vs. 24% vs. 14% vs. 7% vs. 2%, P < 0.001) and more intra-arterial (0% vs. 0% vs. 1% vs. 25% vs. 48%, P < 0.001) and intravitreal (0% vs. 0% vs. 3% vs. 10% vs. 20%, P < 0.001) chemotherapy.

CONCLUSIONS:

Chemoreduction is a safe and effective treatment method for patients with retinoblastoma, demonstrating the best tumor control in the younger age groups.

• Authors: Zeynep Bas, Lauren A Dalvin, Sameeksha Tadepalli, Raksha Rao, Amish Shah, Ann M Leahey, Carol L Shields
• Journal: Asia-Pacific journal of ophthalmology (Philadelphia, Pa.) (Asia Pac J Ophthalmol (Phila)) Vol. 10 Issue 4 Pg. 373-380 (Jan 19 2021) ISSN: 2162-0989 [Electronic] United States
• PMID: 33481399 (Publication Type: Journal Article)
• Copyright: Copyright © 2021 Asia-Pacific Academy of Ophthalmology. Published by Wolters Kluwer Health, Inc. on behalf of the Asia-Pacific Academy of Ophthalmology.

Chemical References

• Vincristine
• Etoposide
• Carboplatin

Topics

• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Carboplatin
• Child, Preschool
• Combined Modality Therapy
• Etoposide
• Eye Enucleation
• Humans
• Infant
• Neoplasm Recurrence, Local
• Retinal Neoplasms (drug therapy)
• Retinoblastoma (drug therapy)
• Retrospective Studies
• Vincristine