Multiagent chemotherapy as neoadjuvant treatment for multifocal intraocular retinoblastoma

Matthew Wilson, Carlos Rodriguez-Galindo, Barrett G. Haik, Darius M. Moshfeghi, Thomas E. Merchant, Charles B. Pratt

Research output: Contribution to journalArticle

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Abstract

Purpose: To evaluate the efficacy of multiagent chemotherapy in the neoadjuvant treatment of retinoblastoma. Design: Noncomparative, prospective case series. Participants: Twenty consecutive patients with multifocal intraocular retinoblastoma (4 unilateral, 16 bilateral [36 eyes]). Intervention: Eight cycles of chemotherapy with carboplatin and vincristine were administered at 3-week intervals over a 6-month period. Supplemental therapy was withheld until disease progression was documented. Main Outcome Measures: Disease progression (defined as tumor growth, vitreous or subretinal seed progression, and new tumor formation), delay of external beam radiotherapy, and ocular survival. Results: Thirty-six eyes were treated. Eighteen eyes had Reese-Ellsworth group I-III tumors, and 16 eyes had Reese-Ellsworth group IV-V tumors at diagnosis. Two patients, who had unilateral disease at diagnosis, subsequently had tumors develop in the contralateral eye. Nineteen of 20 patients (95%) completed eight cycles of chemotherapy without disease progression. Three eyes of three different patients were successfully treated with chemotherapy alone. Thirty-three of 36 eyes (92%) progressed after completion of chemotherapy: 15 of the 18 eyes (83.3%) with Reese-Ellsworth group I-III and 16 of 16 eyes (100%) with Reese-Ellsworth group IV-V tumors. Seventeen eyes (52%) had growth of a tumor, whereas 14 eyes (42%) had progressive vitreous seeding, and 2 eyes (6%) had new tumors develop. Fifteen eyes (42%) required external beam radiotherapy. Twenty-nine of 36 (80.5%) eyes were salvaged. The median follow-up after chemotherapy was 19 months (range, 3-42 months). Conclusions: Multiagent chemotherapy alone does not ensure a cure for multifocal intraocular retinoblastoma. Supplemental focal therapy is needed to control disease progression.

Original languageEnglish (US)
Pages (from-to)2106-2114
Number of pages9
JournalOphthalmology
Volume108
Issue number11
DOIs
StatePublished - Nov 15 2001

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Neoadjuvant Therapy
Retinoblastoma
Drug Therapy
Disease Progression
Neoplasms
Radiotherapy
Carboplatin
Vincristine
Growth

All Science Journal Classification (ASJC) codes

  • Ophthalmology

Cite this

Wilson, M., Rodriguez-Galindo, C., Haik, B. G., Moshfeghi, D. M., Merchant, T. E., & Pratt, C. B. (2001). Multiagent chemotherapy as neoadjuvant treatment for multifocal intraocular retinoblastoma. Ophthalmology, 108(11), 2106-2114. https://doi.org/10.1016/S0161-6420(01)00805-3

Multiagent chemotherapy as neoadjuvant treatment for multifocal intraocular retinoblastoma. / Wilson, Matthew; Rodriguez-Galindo, Carlos; Haik, Barrett G.; Moshfeghi, Darius M.; Merchant, Thomas E.; Pratt, Charles B.

In: Ophthalmology, Vol. 108, No. 11, 15.11.2001, p. 2106-2114.

Research output: Contribution to journalArticle

Wilson, M, Rodriguez-Galindo, C, Haik, BG, Moshfeghi, DM, Merchant, TE & Pratt, CB 2001, 'Multiagent chemotherapy as neoadjuvant treatment for multifocal intraocular retinoblastoma', Ophthalmology, vol. 108, no. 11, pp. 2106-2114. https://doi.org/10.1016/S0161-6420(01)00805-3
Wilson M, Rodriguez-Galindo C, Haik BG, Moshfeghi DM, Merchant TE, Pratt CB. Multiagent chemotherapy as neoadjuvant treatment for multifocal intraocular retinoblastoma. Ophthalmology. 2001 Nov 15;108(11):2106-2114. https://doi.org/10.1016/S0161-6420(01)00805-3
Wilson, Matthew ; Rodriguez-Galindo, Carlos ; Haik, Barrett G. ; Moshfeghi, Darius M. ; Merchant, Thomas E. ; Pratt, Charles B. / Multiagent chemotherapy as neoadjuvant treatment for multifocal intraocular retinoblastoma. In: Ophthalmology. 2001 ; Vol. 108, No. 11. pp. 2106-2114.
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abstract = "Purpose: To evaluate the efficacy of multiagent chemotherapy in the neoadjuvant treatment of retinoblastoma. Design: Noncomparative, prospective case series. Participants: Twenty consecutive patients with multifocal intraocular retinoblastoma (4 unilateral, 16 bilateral [36 eyes]). Intervention: Eight cycles of chemotherapy with carboplatin and vincristine were administered at 3-week intervals over a 6-month period. Supplemental therapy was withheld until disease progression was documented. Main Outcome Measures: Disease progression (defined as tumor growth, vitreous or subretinal seed progression, and new tumor formation), delay of external beam radiotherapy, and ocular survival. Results: Thirty-six eyes were treated. Eighteen eyes had Reese-Ellsworth group I-III tumors, and 16 eyes had Reese-Ellsworth group IV-V tumors at diagnosis. Two patients, who had unilateral disease at diagnosis, subsequently had tumors develop in the contralateral eye. Nineteen of 20 patients (95{\%}) completed eight cycles of chemotherapy without disease progression. Three eyes of three different patients were successfully treated with chemotherapy alone. Thirty-three of 36 eyes (92{\%}) progressed after completion of chemotherapy: 15 of the 18 eyes (83.3{\%}) with Reese-Ellsworth group I-III and 16 of 16 eyes (100{\%}) with Reese-Ellsworth group IV-V tumors. Seventeen eyes (52{\%}) had growth of a tumor, whereas 14 eyes (42{\%}) had progressive vitreous seeding, and 2 eyes (6{\%}) had new tumors develop. Fifteen eyes (42{\%}) required external beam radiotherapy. Twenty-nine of 36 (80.5{\%}) eyes were salvaged. The median follow-up after chemotherapy was 19 months (range, 3-42 months). Conclusions: Multiagent chemotherapy alone does not ensure a cure for multifocal intraocular retinoblastoma. Supplemental focal therapy is needed to control disease progression.",
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AU - Rodriguez-Galindo, Carlos

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N2 - Purpose: To evaluate the efficacy of multiagent chemotherapy in the neoadjuvant treatment of retinoblastoma. Design: Noncomparative, prospective case series. Participants: Twenty consecutive patients with multifocal intraocular retinoblastoma (4 unilateral, 16 bilateral [36 eyes]). Intervention: Eight cycles of chemotherapy with carboplatin and vincristine were administered at 3-week intervals over a 6-month period. Supplemental therapy was withheld until disease progression was documented. Main Outcome Measures: Disease progression (defined as tumor growth, vitreous or subretinal seed progression, and new tumor formation), delay of external beam radiotherapy, and ocular survival. Results: Thirty-six eyes were treated. Eighteen eyes had Reese-Ellsworth group I-III tumors, and 16 eyes had Reese-Ellsworth group IV-V tumors at diagnosis. Two patients, who had unilateral disease at diagnosis, subsequently had tumors develop in the contralateral eye. Nineteen of 20 patients (95%) completed eight cycles of chemotherapy without disease progression. Three eyes of three different patients were successfully treated with chemotherapy alone. Thirty-three of 36 eyes (92%) progressed after completion of chemotherapy: 15 of the 18 eyes (83.3%) with Reese-Ellsworth group I-III and 16 of 16 eyes (100%) with Reese-Ellsworth group IV-V tumors. Seventeen eyes (52%) had growth of a tumor, whereas 14 eyes (42%) had progressive vitreous seeding, and 2 eyes (6%) had new tumors develop. Fifteen eyes (42%) required external beam radiotherapy. Twenty-nine of 36 (80.5%) eyes were salvaged. The median follow-up after chemotherapy was 19 months (range, 3-42 months). Conclusions: Multiagent chemotherapy alone does not ensure a cure for multifocal intraocular retinoblastoma. Supplemental focal therapy is needed to control disease progression.

AB - Purpose: To evaluate the efficacy of multiagent chemotherapy in the neoadjuvant treatment of retinoblastoma. Design: Noncomparative, prospective case series. Participants: Twenty consecutive patients with multifocal intraocular retinoblastoma (4 unilateral, 16 bilateral [36 eyes]). Intervention: Eight cycles of chemotherapy with carboplatin and vincristine were administered at 3-week intervals over a 6-month period. Supplemental therapy was withheld until disease progression was documented. Main Outcome Measures: Disease progression (defined as tumor growth, vitreous or subretinal seed progression, and new tumor formation), delay of external beam radiotherapy, and ocular survival. Results: Thirty-six eyes were treated. Eighteen eyes had Reese-Ellsworth group I-III tumors, and 16 eyes had Reese-Ellsworth group IV-V tumors at diagnosis. Two patients, who had unilateral disease at diagnosis, subsequently had tumors develop in the contralateral eye. Nineteen of 20 patients (95%) completed eight cycles of chemotherapy without disease progression. Three eyes of three different patients were successfully treated with chemotherapy alone. Thirty-three of 36 eyes (92%) progressed after completion of chemotherapy: 15 of the 18 eyes (83.3%) with Reese-Ellsworth group I-III and 16 of 16 eyes (100%) with Reese-Ellsworth group IV-V tumors. Seventeen eyes (52%) had growth of a tumor, whereas 14 eyes (42%) had progressive vitreous seeding, and 2 eyes (6%) had new tumors develop. Fifteen eyes (42%) required external beam radiotherapy. Twenty-nine of 36 (80.5%) eyes were salvaged. The median follow-up after chemotherapy was 19 months (range, 3-42 months). Conclusions: Multiagent chemotherapy alone does not ensure a cure for multifocal intraocular retinoblastoma. Supplemental focal therapy is needed to control disease progression.

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