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At least 307 records · Page 17Linked to original sources

Chemoreduction for retinoblastoma: analysis of tumor control and risks for recurrence in 457 tumors.

PURPOSE: To evaluate individual tumor control following chemoreduction for retinoblastoma. METHODS: Prospective nonrandomized single-center case series of 457 retinoblastomas managed with six cycles of chemoreduction (vincristine, etoposide, and carboplatin). The tumors were then managed with chemoreduction alone (group A) or chemoreduction combined with thermotherapy (group B), cryotherapy (group C), or both thermotherapy and cryotherapy (group D). The main outcome measure was development of tumor recurrence. RESULTS: Of 457 retinoblastomas, 63 (14%) were in group A, 256 (56%) in group B, 127 (28%) in group C, and 11 (2%) in group D. The tumor was located in the macula in 33 (52%) of group A, 109 (43%) of group B, 3 (2%) of group C, and 1 (9%) of group D. Using Kaplan-Meier analysis, recurrence of the individual retinoblastoma at 7 years was found in 45% of group A and in 18% of combined groups B, C, and D. Treatment of the 93 tumor recurrences included thermotherapy, cryotherapy, or plaque radiotherapy in 62 cases (67%) and external beam radiotherapy or enucleation in 31 cases (33%). Risk factors predictive of tumor recurrence by multivariate analysis included macular tumor location for all groups and, additionally, female sex for group A and increasing tumor thickness for groups B, C, and D. CONCLUSIONS: Chemoreduction alone or combined with cryotherapy and/or thermotherapy is effective for treatment of retinoblastoma, but tumor recurrence is greatest for those located in the macula and those with greater thickness. Globe salvage is usually achieved despite tumor recurrence.

Adolescent↗

[Clinical problems of radiotherapy in pediatric oncology].

The main principles of radiation therapy as well as the role of ratio Integral Dose/Total Dose in radiation treatment of malignant tumors in children are considered. Indications for radiation therapy of nephroblastomas and peculiarities of radiation treatment of haemangiomas are described. Expedience is proved of radiation of only the liver part affected by neuroblastoma. Tactics of radiation therapy of eosinophilic granuloma of bones in analyzed. Possibility of conservative therapy including radiation component in treatment of retinoblastoma in children is discussed.

Adolescent↗

[Unilateral retinoblastomas with late bilateralization. Three case reports].

Three cases of unilateral retinoblastoma with late bilateralization are presented in this study. The rare occurrence of this event underlines the need for prolonged follow-up in the fellow-eye, even in the absence of familial retinoblastoma. In these three cases, the first affected eye was enucleated after a diagnosis made at three months, sixteen months and three years of age. New tumors appeared in the second eye when the children were sixteen years old in one case and five years old in two cases.

Adolescent↗

Comparison of retinoblastoma reduction for chemotherapy vs external beam radiotherapy.

OBJECTIVE: To determine the time course and extent of tumor reduction associated with systemic chemotherapy or external beam radiotherapy (EBRT) in the treatment of advanced intraocular retinoblastoma. METHODS: Retrospective review of children with Reese-Ellsworth stages IV and V retinoblastoma undergoing primary globe-conserving therapy with either systemic chemoreduction or EBRT. Study variables were recorded at baseline, at monthly intervals for the first 6 months, and at 12 months after the initiation of treatment. Tumor volumes were calculated using basal area and height values determined by ultrasonography, physical examination, and fundus photographic review. MAIN OUTCOME MEASURES: Outcome measures included tumor volume, tumor reduction, regression pattern, treatment-related complications, metastases, and survival. RESULTS: Twenty-six eyes of 26 patients were evaluated for tumor response; 18 patients were treated with systemic chemotherapy and 8 patients were treated with EBRT. Median follow-up was 36 months. A mean 68% reduction in tumor volume occurred after 1 cycle of chemotherapy compared with a 12% reduction at a similar time point (1 month) after initiation of EBRT (P<.004). There was no statistically significant difference in tumor volume reduction between treatment modalities at the 12-month follow-up visit. Both systemic chemoreduction and EBRT achieved 100% globe conservation and 100% patient survival in this series. CONCLUSIONS: Retinoblastoma reduction exhibits a differential time course based on the applied primary treatment. Systemic chemotherapy is associated with earlier tumor reduction than EBRT.

Antineoplastic Combined Chemotherapy Protocols↗