Original articleCauses of chemoreduction failure in retinoblastoma and analysis of associated factors leading to eventual treatment with external beam radiotherapy and enucleation☆
Section snippets
Materials and methods
Between October 1998 and January 2003, 105 eyes of 71 patients with intraocular retinoblastoma underwent chemoreduction treatment. The chemoreduction protocol was approved by the pediatric oncology review board. Informed consent was obtained from all patients. The chemotherapeutic agents employed in the protocol included IV vincristine, etoposide, and carboplatin, as shown in Table 1. Chemoreduction therapy consisted of 6 treatments administered at monthly intervals. Examination under
Results
Of the 71 patients included in this study, 40 had bilateral retinoblastoma, and 31 had unilateral retinoblastoma. A total of 105 eyes were included in the study. Ten patients had a family history of retinoblastoma. Six eyes of 6 patients with bilateral retinoblastoma had been enucleated elsewhere because of advanced intraocular disease before being referred to us. Of the 71 patients, 35 were male and 36 were female. The mean age of the patients was 20.8 months (range: 2–96).
The distribution of
Discussion
The use of chemotherapy in the treatment of intraocular retinoblastoma dates back nearly 50 years. Intravenous nitrogen mustard was the first chemotherapeutic drug used in the management of this condition.15, 16 Later, improved ocular salvage rates using intracarotid triethylenemelamine in combination with external beam radiotherapy were reported.17 Since that time, there have been several reports on the use of chemotherapy, particularly for extraocular retinoblastoma.18, 19, 20 The use of
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Manuscript no. 230645.
The authors have no proprietary interest in the instruments or products used in this article.