April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Long-Term Outcomes of Group C Eyes in Retinoblastoma Patients Treated With Chemoreduction and Low-Dose IMRT as Salvage
Author Affiliations & Notes
  • Lilangi Ediriwickrema
    Ophthalmology, University of Southern California, Los Angeles, CA
  • Jesse L Berry
    The Vision Center, Children’s Hospital Los Angeles, Los Angeles, CA
  • Rima Jubran
    The Children’s Center for Cancer and Blood Diseases, Children’s Hospital of Los Angeles, Los Angeles, CA
  • Thomas C Lee
    Ophthalmology, University of Southern California, Los Angeles, CA
    The Vision Center, Children’s Hospital Los Angeles, Los Angeles, CA
  • A. Linn Murphree
    The Vision Center, Children’s Hospital Los Angeles, Los Angeles, CA
  • Jonathan W Kim
    Ophthalmology, University of Southern California, Los Angeles, CA
    The Vision Center, Children’s Hospital Los Angeles, Los Angeles, CA
  • Footnotes
    Commercial Relationships Lilangi Ediriwickrema, None; Jesse Berry, None; Rima Jubran, None; Thomas Lee, None; A. Linn Murphree, None; Jonathan Kim, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 3089. doi:https://doi.org/
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      Lilangi Ediriwickrema, Jesse L Berry, Rima Jubran, Thomas C Lee, A. Linn Murphree, Jonathan W Kim; Long-Term Outcomes of Group C Eyes in Retinoblastoma Patients Treated With Chemoreduction and Low-Dose IMRT as Salvage. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3089. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

To evaluate outcomes of Group C eyes of unilateral and bilateral retinoblastoma patients treated with primary chemoreduction and intensity modulated radiotherapy (IMRT) as salvage.

 
Methods
 

Retrospective chart review of patients diagnosed with unilateral and bilateral retinoblastoma and designated Group C in at least one eye from January 1, 1991 to December 31, 2011. Overall, 36 Group C eyes of 36 patients were included; 26 had bilateral disease. Primary chemoreduction (CRD) with vincristine, etoposide, and carboplatin with local consolidation was administered, followed by external beam radiation in the form of low-dose intensity-modulated radiation therapy (IMRT) as salvage for persistent or recurrent tumor. Primary outcome measure was globe salvage.

 
Results
 

Of the 26 Group C eyes in patients with bilateral retinoblastoma, none were enucleated primarily; 5 of the 10 unilateral Group C eyes were enucleated primarily. Thus, CRD and local therapy was used to treat 31 retinoblastoma eyes. CRD cured 22 of 31 (71%) Group C eyes. Recurrences were found in 9 eyes; five underwent secondary enucleation due to poor visual prognosis, and four received low dose IMRT as salvage therapy. Of the 4 irradiated eyes, 100% were salvaged and none required enucleation (Figure 1). Final visual acuity ranged from 20/20 to no light perception with 13 eyes having 20/80 or better visual acuity in the bilateral retinoblastoma patients. Average follow-up was 98 months (range 22 to 211 months). Chemoreduction was well tolerated by all patients.

 
Conclusions
 

Estimates of eye survival of Group C eyes in bilateral patients at 12 months is 91.7%; at 60 months eye survival is estimated to be 87.5% (Figure 2). Systemic treatment for retinoblastoma demonstrated an extremely high rate of globe preservation with acceptable complications and many eyes retaining functional vision.

 
 
Figure 1: Treatment Modality and Percent Recurrence of Group C Eyes (n=31 eyes)
 
Figure 1: Treatment Modality and Percent Recurrence of Group C Eyes (n=31 eyes)
 
 
Figure 2: Kaplan-Meier Estimate of Eye Survival of Group C Eyes in Bilateral Patients (n=24 eyes)
 
Figure 2: Kaplan-Meier Estimate of Eye Survival of Group C Eyes in Bilateral Patients (n=24 eyes)
 
Keywords: 744 tumors • 624 oncology • 462 clinical (human) or epidemiologic studies: outcomes/complications  
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