The International Classification of Retinoblastoma predicts chemoreduction success

Ophthalmology. 2006 Dec;113(12):2276-80. doi: 10.1016/j.ophtha.2006.06.018. Epub 2006 Sep 25.


Purpose: To evaluate the reliability of the International Classification of Retinoblastoma (ICRB) for predicting treatment success with chemoreduction (CRD).

Design: Noncomparative interventional case series.

Participants: Two hundred forty-nine consecutive eyes.

Methods: All eyes were treated with CRD and were classified according to the ICRB: group A included those eyes with retinoblastoma </=3 mm; group B included those eyes with retinoblastoma >3 mm, macular location, or minor subretinal fluid; group C included those eyes with retinoblastoma with localized seeds; group D included those eyes with retinoblastoma with diffuse seeds; group E included those eyes with massive retinoblastoma necessitating enucleation. The CRD regimen included vincristine, etoposide, and carboplatin for 6 cycles plus local consolidation with thermotherapy or cryotherapy.

Main outcome measure: Chemoreduction success, defined as avoidance of external beam radiotherapy or enucleation.

Results: Of the 249 eyes, 23 (9%) were in group A, 96 (39%) were in group B, 21 (8%) were in group C, and 109 (44%) were in group D. In this series, group E eyes were managed with enucleation. Treatment success was achieved in 100% of group A, 93% of group B, 90% of group C, and 47% of group D eyes.

Conclusions: The ICRB can be of assistance in predicting CRD success for retinoblastoma. Additional treatment methods are necessary to salvage more group D eyes.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Carboplatin / therapeutic use
  • Child
  • Child, Preschool
  • Combined Modality Therapy
  • Cryotherapy
  • Etoposide / therapeutic use
  • Humans
  • Hyperthermia, Induced
  • Infant
  • International Classification of Diseases*
  • Reproducibility of Results
  • Retinal Neoplasms / classification*
  • Retinal Neoplasms / drug therapy*
  • Retinal Neoplasms / pathology
  • Retinoblastoma / classification*
  • Retinoblastoma / drug therapy*
  • Retinoblastoma / pathology
  • Treatment Outcome
  • Vincristine / therapeutic use


  • Vincristine
  • Etoposide
  • Carboplatin

Supplementary concepts

  • CEV regimen