May 2006
Volume 47, Issue 13
ARVO Annual Meeting Abstract  |   May 2006
Treatment Outcomes and Globe Salvage Using Second Line Chemotherapy in Advanced Retinoblastoma
Author Affiliations & Notes
  • P. Mruthyunjaya
    Ophthalmology, Duke University Eye Center, Durham, NC
  • J.E. Kingston
    Pediatric Oncology, Royal London/Great Ormond Street NHS Trust, London, United Kingdom
  • J.L. Hungerford
    Ocular Oncology, Moorfields Eye Hospital, London, United Kingdom
  • Footnotes
    Commercial Relationships  P. Mruthyunjaya, None; J.E. Kingston, None; J.L. Hungerford, None.
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science May 2006, Vol.47, 2291. doi:
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      P. Mruthyunjaya, J.E. Kingston, J.L. Hungerford; Treatment Outcomes and Globe Salvage Using Second Line Chemotherapy in Advanced Retinoblastoma . Invest. Ophthalmol. Vis. Sci. 2006;47(13):2291.

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

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Purpose: : To describe the treatment outcomes using second line chemotherapy (SLC) with intravenous vincristine, doxorubicin, and ifosfamide (IVAd) in eyes with relapsed or refractory retinoblastoma (Rb)

Methods: : Non–comparative, consecutive, interventional series of eyes treated with IVAd following first line chemotherapy failure with vincristine, etoposide, and carboplatin. Indications and outcomes, including globe salvage (treatment success) were identified.

Results: : 21 eyes in 14 children received SLC with IVAd. Nine (43%) were Reese–Ellsworth group IVa or worse. New vitreous disease was the most common indication (n=6). Median follow up was 2 years. Twelve (57%) eyes were salvaged, nine (43%) with SLC and local therapy alone and 3 (14%) with additional external beam radiotherapy (EBRT). Eight (38%) eyes were enucleated. Relapse after SLC was correlated with treatment failure (p<0.001). Eyes needing EBRT were also likely to fail (p<0.01). Median time to failure was 282 days. No local or systemic metastases, deaths or second tumors were documented.

Conclusions: : Second line chemotherapy with IVAd represents an option for globe sparing therapy in refractory Rb, especially with vitreous disease. This strategy allowed globe salvage in 57% of eyes. The impact of IVAd on second cancer risk in genetic Rb patients is unknown and must be considered in these patients.

Keywords: retinoblastoma • tumors 

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