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Systemic carboplatin for retinoblastoma: change in tumour size over time
  1. D H Abramson1,2,4,
  2. S D Lawrence2,
  3. K L Beaverson1,3,
  4. T C Lee1,2,
  5. I S Rollins1,
  6. I J Dunkel4
  1. 1Ophthalmic Oncology Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
  2. 2Department of Ophthalmology, New York Presbyterian Hospital-Weill Cornell Medical College, New York, NY, USA
  3. 3Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
  4. 4Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
  1. Correspondence to: David H Abramson MD, 70 East 66th Street, New York, NY 10021, USA; DHAMDaol.com

Abstract

Background/aim: Chemotherapy for intraocular retinoblastoma is used to shrink individual retinal tumours to a size amenable to focal treatments. Quantitative data regarding retinal tumour response following treatment with primary systemic carboplatin are reported.

Methods: Changes in area and largest basal diameter of tumours that were exposed to carboplatin, had no concomitant focal treatment, and had digital funduscopic photography performed before and after treatment, were measured. Response was evaluated.

Results: 36 tumours were measured following one treatment: 34/36 (94.4%) responded, with a 37.1% mean decrease in area (median  = 37.0%; range 4.0%–76.7%). Mean reduction in basal diameter was 21.3% (med = 21.0%; −7.9%–52.5%). 20 tumours were treated with a second cycle: 15/20 (75.0%) responded. Mean decrease in area was 17.8% (med = 15.3%; −7.0%–49.7%). The mean cumulative decrease in area after two treatments was 55.1% (med = 56.2%; 33.0%–74.5%). Mean cumulative reduction in basal diameter was 33.6% (med = 33.6%; 10.9%–53.2%). 12 tumours were treated with a third cycle: 3/12 (25.0%) responded, 8/12 were stable, and one progressed. Mean decrease in area was 5.4% (med = 7.2%; −17.7%–20.6%). Cumulative decrease in area after three treatments was 58.1% (med = 57.3%; 34.8%–77.2%). Mean cumulative reduction in basal diameter was 38.8% (med = 38.2%; 19.1%–54.1%).

Conclusions: Carboplatin caused measurable shrinkage of retinoblastoma tumours. Response was greatest following the initial treatment and decreased with subsequent treatments.

  • CBC, complete blood count
  • CTT, chemothermotherapy
  • dd, disc diameter
  • EBR, external beam radiotherapy
  • RE, Reese-Ellsworth
  • TTT, transpupillary thermotherapy
  • VEC, vincristine, etoposide, and carboplatin
  • retinoblastoma
  • carboplatin
  • chemoreduction
  • chemotherapy
  • CBC, complete blood count
  • CTT, chemothermotherapy
  • dd, disc diameter
  • EBR, external beam radiotherapy
  • RE, Reese-Ellsworth
  • TTT, transpupillary thermotherapy
  • VEC, vincristine, etoposide, and carboplatin
  • retinoblastoma
  • carboplatin
  • chemoreduction
  • chemotherapy

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Footnotes

  • Supported in part by the Fund for Ophthalmic Knowledge, New York, NY, USA.

  • Competing interests: none declared

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