Retinoblastoma regression patterns following chemoreduction and adjuvant therapy in 557 tumors

Arch Ophthalmol. 2009 Mar;127(3):282-90. doi: 10.1001/archophthalmol.2008.626.

Abstract

Objective: To evaluate retinoblastoma regression patterns following chemoreduction and adjuvant therapy.

Participants: A total of 557 retinoblastomas.

Methods: A retrospective medical record review following 6 cycles of chemoreduction and tumor consolidation (thermotherapy or cryotherapy). Regression patterns included type 0 (no remnant), type 1 (calcified remnant), type 2 (noncalcified remnant), type 3 (partially calcified remnant), and type 4 (flat scar).

Main outcome measures: Regression pattern.

Results: Retinoblastoma regressions were type 0 (n = 10), type 1 (n = 75), type 2 (n = 28), type 3 (n = 127), and type 4 (n = 317). Tumors with an initial thickness of 3 mm or less regressed most often to type 4 (92%), those 3 to 8 mm regressed to type 3 (34%) or type 4 (40%), and those thicker than 8 mm regressed to type 1 (40%) or type 3 (49%). Factors predictive of type 1 regression included larger tumor base and closer foveolar proximity. Factors predictive of type 3 included older age, larger tumor base, macular location, closer foveolar proximity, and lack of consolidation. Factors predictive of type 4 included familial hereditary pattern, smaller tumor base, greater foveolar distance, and tumor consolidation.

Conclusions: Following chemoreduction, most small retinoblastomas result in a flat scar, intermediate tumors in a flat or partially calcified remnant, and large tumors in a more completely calcified remnant.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Calcinosis / pathology
  • Carboplatin / therapeutic use
  • Child, Preschool
  • Cryotherapy*
  • Etoposide / therapeutic use
  • Female
  • Humans
  • Hyperthermia, Induced*
  • Infant
  • Male
  • Retinal Neoplasms / classification
  • Retinal Neoplasms / pathology*
  • Retinal Neoplasms / therapy
  • Retinoblastoma / classification
  • Retinoblastoma / pathology*
  • Retinoblastoma / therapy
  • Retrospective Studies
  • Vincristine / therapeutic use

Substances

  • Vincristine
  • Etoposide
  • Carboplatin

Supplementary concepts

  • CEV regimen