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Swathi Kaliki, Sanket U. Shah, Ann M. Leahey, Carlos Bianciotto, Carol L. Shields; Postenucleation Adjuvant Chemotherapy With Vincristine, Etoposide And Carboplatin In Patients With High Risk Retinoblastoma. Invest. Ophthalmol. Vis. Sci. 2011;52(14):2109.
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To determine the efficacy of postenucleation adjuvant therapy with Vincristine, Etoposide and Carboplatin (VEC) in preventing metastasis in high-risk retinoblastoma (RB) patients.
Retrospective, non-randomized, non-comparative, interventional case series. RB patients with high-risk histopathologic features after enucleation were included in this study. All patients in this series received a standard dose intravenous chemotherapy with VEC for a mean of 6 sessions (median, 6; range 4 -6).
Sixty eyes of 59 patients with high-risk retinoblastoma were studied. There were 32 (54%) males and 27(46%) females, with a mean age of 41 months (median, 28; range 3-368 months). Histopathologic risk factors included anterior chamber seeding (32%), infiltration of the iris (28%), ciliary body (22%), choroid (37%), pre-laminar optic nerve (15%), optic nerve lamina cribrosa (12%), retrolaminar optic nerve (27%), optic nerve transection site (2%), sclera (8%) and extrascleral structures (3%). A single histopathologic high-risk factor was present in 26 (43%) eyes while 34 (57%) eyes manifested 2 or more high-risk characteristics. Based on previously published series, these findings carry a 24% risk for retinoblastoma metastasis. In the present series, none of the patients developed distant metastasis during a mean follow-up period of 61 months (median, 50; range 12-202 months).
Post-enucleation adjuvant chemotherapy with VEC is effective in preventing distant metastasis in patients with high-risk retinoblastoma.
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