Purpose To evaluate retinoblastoma control following chemoreduction. Design In terventional case series. Methods Prospective. Setting Single center trial. Pati ent population 457 retinoblastomas in 193 eyes of 125 pat...Purpose To evaluate retinoblastoma control following chemoreduction. Design In terventional case series. Methods Prospective. Setting Single center trial. Pati ent population 457 retinoblastomas in 193 eyes of 125 patients. Nonrandomized, n oncomparative study. Intervention All patients received intravenous vincristine, etoposide, and carboplatin,. The tumors were managed with chemoreduction alone (group W) or chemoreduction combined with thermotherapy (group X), cryotherapy ( group Y), or both thermotherapy and cryotherapy (group Z). Main outcome measure Tumor recurrence in each treatment group. Results Of 457 retinoblastomas, 63 (14 %) were in groupW, 256 (56%) in group X, 127 (28%) in group Y, and 11 (2%) i n group Z. The tumor was located in the macula in 33 (52%) of group W, 109 (43 %) of group X, 3 (2%) of group Y, and 9 (1%) of group Z. The mean tumor thick ness at initial examination was 7 mm for group W, 4 mm for group X, 2 mm for gro up Y, and 3 mm for group Z. Using Kaplan-Meier estimates, recurrence of the ind ividual retinoblastoma at 7 years was found in 45%of groupWand 18%for combined groups X, Y, and Z. Risk factors predictive of tumor recurrence by multivariate analysis included macular tumor location for all groups and additionally female gender for group W and increasing tumor thickness for groups X, Y, and Z. Concl usions Chemoreduction alone or combined with cryotherapy or thermotherapy is eff ective for treatment of retinoblastoma, but tumor recurrence rate is highest for those located in the macula and those with greater thickness.展开更多
文摘Purpose To evaluate retinoblastoma control following chemoreduction. Design In terventional case series. Methods Prospective. Setting Single center trial. Pati ent population 457 retinoblastomas in 193 eyes of 125 patients. Nonrandomized, n oncomparative study. Intervention All patients received intravenous vincristine, etoposide, and carboplatin,. The tumors were managed with chemoreduction alone (group W) or chemoreduction combined with thermotherapy (group X), cryotherapy ( group Y), or both thermotherapy and cryotherapy (group Z). Main outcome measure Tumor recurrence in each treatment group. Results Of 457 retinoblastomas, 63 (14 %) were in groupW, 256 (56%) in group X, 127 (28%) in group Y, and 11 (2%) i n group Z. The tumor was located in the macula in 33 (52%) of group W, 109 (43 %) of group X, 3 (2%) of group Y, and 9 (1%) of group Z. The mean tumor thick ness at initial examination was 7 mm for group W, 4 mm for group X, 2 mm for gro up Y, and 3 mm for group Z. Using Kaplan-Meier estimates, recurrence of the ind ividual retinoblastoma at 7 years was found in 45%of groupWand 18%for combined groups X, Y, and Z. Risk factors predictive of tumor recurrence by multivariate analysis included macular tumor location for all groups and additionally female gender for group W and increasing tumor thickness for groups X, Y, and Z. Concl usions Chemoreduction alone or combined with cryotherapy or thermotherapy is eff ective for treatment of retinoblastoma, but tumor recurrence rate is highest for those located in the macula and those with greater thickness.
