The International Classification of Retinoblastoma Predicts Chemoreduction Success
Received 9 November 2005; accepted 20 June 2006. published online 21 September 2006.
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.
1Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.
2The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania.
Reprint requests to Carol L. Shields, MD, Ocular Oncology Service, Suite 1440, Wills Eye Hospital, 840 Walnut Street, Philadelphia, PA 19107.
Manuscript no. 2005-1095.
Supported by a donation from Michael, Bruce, and Ellen Ratner, New York, New York (JAS, CLS); the Paul Kayser International Award of Merit in Retina Research, Houston, Texas (JAS); the National Institutes of Health, Bethesda, Maryland (NIH R25 training grant [AKA]); Mellon Charitable Giving from the Martha W. Rogers Charitable Trust, Philadelphia, Pennsylvania (CLS); the Macula Foundation, New York, New York (CLS); and the Eye Tumor Research Foundation, Philadelphia, Pennsylvania (CLS, JAS).
ABSTRACT