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Successful treatment of metastatic retinoblastoma

  1. Ira J. Dunkel M.D.1,†,*,
  2. Alexander Aledo M.D.2,
  3. Nancy A. Kernan M.D.1,
  4. Brian Kushner M.D.1,
  5. Lisa Bayer C.P.N.P.2,
  6. Smitha V. Gollamudi M.D.3,
  7. Jonathan L. Finlay M.B., Ch.B.1,
  8. David H. Abramson M.D.4

Article first published online: 13 NOV 2000

DOI: 10.1002/1097-0142(20001115)89:10<2117::AID-CNCR12>3.0.CO;2-9

Issue

Cancer

Cancer

Volume 89, Issue 10, pages 2117–2121, 15 November 2000

Additional Information

How to Cite

Dunkel, I. J., Aledo, A., Kernan, N. A., Kushner, B., Bayer, L., Gollamudi, S. V., Finlay, J. L. and Abramson, D. H. (2000), Successful treatment of metastatic retinoblastoma. Cancer, 89: 2117–2121. doi: 10.1002/1097-0142(20001115)89:10<2117::AID-CNCR12>3.0.CO;2-9

Author Information

  1. 1

    Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, New York

  2. 2

    Department of Pediatrics, New York Presbyterian Hospital, New York, New York

  3. 3

    Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York

  4. 4

    Department of Ophthalmology, New York Presbyterian Hospital, New York, New York

  1. †

    Fax: (212) 717-3239

*Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, Box 185, 1275 York Avenue, New York, NY 10021

Publication History

  1. Issue published online: 13 NOV 2000
  2. Article first published online: 13 NOV 2000
  3. Manuscript Revised: 29 JUN 2000
  4. Manuscript Accepted: 29 JUN 2000
  5. Manuscript Received: 8 MAR 2000

Funded by

  • Louis and Rachel Rudin Foundation

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Keywords:

  • retinoblastoma;
  • chemotherapy;
  • adjuvant hematopoietic stem cell transplantation;
  • radiation therapy

Four consecutive children with metastatic retinoblastoma achieved long term event free survival with intensive chemotherapy and radiation therapy.

Abstract

BACKGROUND

In the past, patients with metastatic retinoblastoma have had a poor prognosis when treated with conventional modalities. In the current study, the authors evaluated the use of combined intensive conventional chemotherapy, high dose chemotherapy with autologous stem cell rescue (ASCR), and radiation therapy.

METHODS

Four patients with metastatic retinoblastoma were treated. All had orbital and bone marrow metastases. In addition, three patients had bone metastases and two patients had liver metastases. None had central nervous system disease. Patients received intensive conventional chemotherapy that included vincristine, cyclophosphamide, etoposide, and either cisplatin or carboplatin. Stem cells were harvested after bone marrow disease was no longer detectable. High dose chemotherapy with carboplatin (500 mg/m2/day × 3 days or area under the curve = 7 via the Calvert formula) and thiotepa (300 mg/m2/day × 3 days) with (n = 3 patients) or without (n = 1 patient) etoposide (250 mg/m2/day × 3 days) was administered with ASCR. Sites that originally harbored bulky disease were irradiated after recovery from the high dose chemotherapy.

RESULTS

The therapy was associated with substantial acute hematopoietic and mucosal toxicities. At last follow-up, all four patients had survived event free from 46–80 months after the diagnosis of metastatic disease.

CONCLUSIONS

The treatment strategy described in the current study is effective for patients with metastatic retinoblastoma that does not involve the central nervous system. However, a multicenter trial should be considered to evaluate it in a larger group of patients. Cancer 2000;89:2117–21. © 2000 American Cancer Society.

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