Treatment of intraocular retinoblastoma with vincristine and carboplatin

被引:111
作者
Rodriguez-Galindo, C
Wilson, MW
Haik, BG
Merchant, TE
Billups, CA
Shah, N
Cain, A
Langston, J
Lipson, M
Kun, LE
Pratt, CB
机构
[1] St Jude Childrens Res Hosp, Dept Hematol Oncol, Div Ophthalmol Radiat Oncol Biostat & Diagnost Im, Memphis, TN 38105 USA
[2] St Jude Childrens Res Hosp, Dept Surg, Div Ophthalmol Radiat Oncol Biostat & Diagnost Im, Memphis, TN 38105 USA
[3] Univ Tennessee, Ctr Hlth Sci, Dept Pediat, Memphis, TN 38163 USA
[4] Univ Tennessee, Ctr Hlth Sci, Dept Ophthalmol, Memphis, TN 38163 USA
[5] Univ Tennessee, Ctr Hlth Sci, Dept Radiat Oncol, Memphis, TN 38163 USA
[6] Univ Tennessee, Ctr Hlth Sci, Dept Radiol, Memphis, TN 38163 USA
关键词
D O I
10.1200/JCO.2003.09.103
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: To evaluate the efficacy of chemoreduction using vincristine and carboplatin in preventing or delaying external-beam radiotherapy (EBRT) or enucleation in patients with intraocular retinoblastoma. Patients and Methods: Twenty-five patients (43 eyes) with newly diagnosed intraocular retinoblastoma received primary treatment with eight courses of vincristine and carboplatin. Focal treatments were delayed until documentation of disease progression. Outcome measures for each eye were length of time to disease progression, avoidance or delay of EBRT, and globe survival. Event-free survival was defined as the length of time to EBRT or enucleation. Results: Disease in all eyes responded to chemotherapy and progressed in only two patients before completion of the eight courses of therapy. Disease in all but four eyes progressed and required focal treatments. Event-free survival estimates at 2 years were 59.2% +/- 12.0% for Reese-Ellsworth group I, II, and III eyes and 26.3% +/- 9.2% for group IV and V eyes. Nineteen eyes (44.2%) required EBRT and 13 eyes (30.2%) were enucleated. The ocular salvage rate was 83.3% for Reese-Ellsworth group I to III eyes and 52.6% for group IV and V eyes. For those patients receiving EBRT, the median time from enrollment to EBRT was 9.5 months (median age at EBRT, 21 months). Conclusion: In combination with appropriate early intensive focal treatments, chemoreduction with vincristine and carboplatin, without etoposide, may be an alternative treatment for patients with early-stage intraocular retinoblastoma, although additional studies are needed. Patients with advanced intraocular disease require more aggressive treatments. (C) 2003 by American Society of Clinical Oncology.
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页码:2019 / 2025
页数:7
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