A 10-year experience of outcome in chemotherapy-treated hereditary retinoblastoma

Acta Ophthalmol. 2014 Aug;92(5):404-11. doi: 10.1111/aos.12282. Epub 2013 Oct 7.

Abstract

Purpose: The aim is to report the 10-year retrospective experience of systemic chemotherapy for a population-based group of patients with hereditary retinoblastoma at a national referral centre. The outcomes include control rates, treatment side-effects, adjuvant therapy, failure rate, survival, secondary cancers and visual acuity.

Methods: All patients (n = 24, 46 eyes) diagnosed with retinoblastoma and treated with systemic chemotherapy at a national referral centre during 2001-2011 were included. Data were extracted from medical records.

Results: The patients were followed for a mean of 60 months (range 13-144). Four-six cycles of VEC was administered to all newly diagnosed group B/C/D/E eyes with bilateral disease and 83% (38 of 46) responded to the treatment. None of the patients discontinued chemotherapy because of adverse reactions. Altogether 26% (12 of 46) of the eyes received second-line therapy (other than thermotherapy, cryotherapy and chemotherapy). The failure rate was 35% (16 of 46) and mortality rate 0%. None of the patients developed CNS manifestations (metastases or trilateral retinoblastoma). One of the patients developed a second primary tumour (osteosarcoma) 4 years following retinoblastoma diagnosis. Altogether 17% (4 of 24) patients received radiation therapy, 28% (13 of 46) of the eyes had to be enucleated, and one patient underwent bilateral enucleation. The age-correlated visual acuity was mean of 73% of expected visual acuity.

Conclusion: Group A/B retinoblastomas have a distinct chemotherapy response, while group C/D/E tumours do not respond as well. The success rate was 65%; while patients have a good prognosis for life, approximately one-third of all hereditary cases received radiation therapy or underwent enucleation.

Keywords: chemotherapy; failure rate; focal therapy; hereditary retinoblastoma; visual acuity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Carboplatin / therapeutic use
  • Child, Preschool
  • Combined Modality Therapy
  • Cryotherapy
  • Etoposide / therapeutic use
  • Female
  • Follow-Up Studies
  • Humans
  • Hyperthermia, Induced
  • Infant
  • Infant, Newborn
  • Male
  • Retinal Neoplasms / drug therapy*
  • Retinal Neoplasms / genetics
  • Retinal Neoplasms / physiopathology
  • Retinoblastoma / drug therapy*
  • Retinoblastoma / genetics
  • Retinoblastoma / physiopathology
  • Retrospective Studies
  • Treatment Outcome
  • Vincristine / therapeutic use
  • Visual Acuity

Substances

  • Vincristine
  • Etoposide
  • Carboplatin

Supplementary concepts

  • CEV regimen