NEW YORK (Reuters Health) Nov 18 - After enucleation for high-risk retinoblastoma, VEC chemotherapy (vincristine, etoposide, carboplatin) very effectively prevents metastasis, according to a report from the Wills Eye Institute in Philadelphia.
From 1994 through 2010, doctors there identified 52 eyes as being at high-risk for metastasis of retinoblastoma, based on tumor invasion into the anterior segment, posterior uvea (3 mm or more), or postlaminar optic nerve, or a combination of any degree of posterior uveal and optic nerve invasion.
These 52 eyes, in 51 children, accounted for 13% of the 406 eyes enucleated for retinoblastoma during the study period, said Dr. Carol L. Shields and colleagues in a paper in this month's Archives of Ophthalmology. The mean age of the high-risk patients at diagnosis was 28 months.
Postoperatively, four patients received four cycles of VEC, and the others received six cycles.
Over an average follow-up of 66 months (range, 12 to 202), repeated examinations and CT and/or MRI studies of the orbit and brain found no instance of metastasis in any patient, Dr. Shields and colleagues report.
A previous series reported metastatic disease in 24% of patients with high-risk retinoblastoma who didn't receive adjuvant chemotherapy, the authors point out.
The only chemotherapy-related complication was one case of pneumonia, and there were no cases of etoposide-related leukemia, according to the research team.
Metastatic retinoblastoma is frequently fatal, the authors say. "On the basis of our results," they conclude, "VEC is impressively effective for postenucleation high-risk RB (retinoblastoma) in the prevention of systemic metastases, thereby improving survival."
SOURCE: http://bit.ly/uPPQbF
Arch Ophthalmol 2011.
From 1994 through 2010, doctors there identified 52 eyes as being at high-risk for metastasis of retinoblastoma, based on tumor invasion into the anterior segment, posterior uvea (3 mm or more), or postlaminar optic nerve, or a combination of any degree of posterior uveal and optic nerve invasion.
These 52 eyes, in 51 children, accounted for 13% of the 406 eyes enucleated for retinoblastoma during the study period, said Dr. Carol L. Shields and colleagues in a paper in this month's Archives of Ophthalmology. The mean age of the high-risk patients at diagnosis was 28 months.
Postoperatively, four patients received four cycles of VEC, and the others received six cycles.
Over an average follow-up of 66 months (range, 12 to 202), repeated examinations and CT and/or MRI studies of the orbit and brain found no instance of metastasis in any patient, Dr. Shields and colleagues report.
A previous series reported metastatic disease in 24% of patients with high-risk retinoblastoma who didn't receive adjuvant chemotherapy, the authors point out.
The only chemotherapy-related complication was one case of pneumonia, and there were no cases of etoposide-related leukemia, according to the research team.
Metastatic retinoblastoma is frequently fatal, the authors say. "On the basis of our results," they conclude, "VEC is impressively effective for postenucleation high-risk RB (retinoblastoma) in the prevention of systemic metastases, thereby improving survival."
SOURCE: http://bit.ly/uPPQbF
Arch Ophthalmol 2011.
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