Premium
Successful treatment of metastatic retinoblastoma
Author(s) -
Dunkel Ira J.,
Aledo Alexander,
Kernan Nancy A.,
Kushner Brian,
Bayer Lisa,
Gollamudi Smitha V.,
Finlay Jonathan L.,
Abramson David H.
Publication year - 2000
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(20001115)89:10<2117::aid-cncr12>3.0.co;2-9
Subject(s) - medicine , thiotepa , carboplatin , etoposide , chemotherapy , vincristine , cyclophosphamide , surgery , retinoblastoma , bone marrow , radiation therapy , carmustine , oncology , cisplatin , biochemistry , chemistry , gene
BACKGROUND In the past, patients with metastatic retinoblastoma have had a poor prognosis when treated with conventional modalities. In the current study, the authors evaluated the use of combined intensive conventional chemotherapy, high dose chemotherapy with autologous stem cell rescue (ASCR), and radiation therapy. METHODS Four patients with metastatic retinoblastoma were treated. All had orbital and bone marrow metastases. In addition, three patients had bone metastases and two patients had liver metastases. None had central nervous system disease. Patients received intensive conventional chemotherapy that included vincristine, cyclophosphamide, etoposide, and either cisplatin or carboplatin. Stem cells were harvested after bone marrow disease was no longer detectable. High dose chemotherapy with carboplatin (500 mg/m 2 /day × 3 days or area under the curve = 7 via the Calvert formula) and thiotepa (300 mg/m 2 /day × 3 days) with (n = 3 patients) or without (n = 1 patient) etoposide (250 mg/m 2 /day × 3 days) was administered with ASCR. Sites that originally harbored bulky disease were irradiated after recovery from the high dose chemotherapy. RESULTS The therapy was associated with substantial acute hematopoietic and mucosal toxicities. At last follow‐up, all four patients had survived event free from 46–80 months after the diagnosis of metastatic disease. CONCLUSIONS The treatment strategy described in the current study is effective for patients with metastatic retinoblastoma that does not involve the central nervous system. However, a multicenter trial should be considered to evaluate it in a larger group of patients. Cancer 2000;89:2117–21. © 2000 American Cancer Society.