Intensive Multimodality Therapy for Stage 4a Metastatic Retinoblastoma Patients

Strategic Insights -

In a newly published study in Pediatric Blood & Cancer, researchers from the United States reported promising results for treating stage 4a metastatic retinoblastoma patients with intensive conventional chemotherapy, high-dose chemotherapy with autologous hematopoietic stem cell rescue, and radiation therapy. The study presented an expanded and updated series of 15 patients, with bone marrow (14), bone (10), orbit (9), and/or liver (4) disease, who received a combination of chemotherapy and radiation therapy. The researchers found that the majority of patients achieved remission, with 10 patients remaining retinoblastoma-free in first remission at a median follow-up of 103 months.

Key Takeaways:

  • 15 patients with stage 4a metastatic retinoblastoma were treated with intensive conventional chemotherapy, high-dose chemotherapy with autologous hematopoietic stem cell rescue, and radiation therapy.
  • The high-dose chemotherapy regimen included carboplatin and thiotepa alone or with etoposide or topotecan.
  • Bone marrow cleared at first post-initiation of chemotherapy examination in all patients, and stem cells were harvested after a median of 3.5 cycles of chemotherapy (range 3-6 cycles).
  • 13 patients received high-dose chemotherapy at a median of 6 months post-diagnosis of metastases (range 4-8 months).
  • 10 patients remained retinoblastoma-free in first remission at a median follow-up of 103 months (range 34-202 months).
  • 3 patients developed secondary osteosarcoma 14, 4, and 9 years after diagnosis of metastatic disease.

Statistics:

  • 15 patients with stage 4a metastatic retinoblastoma were studied.
  • 14 patients had bone marrow disease.
  • 10 patients had bone disease.
  • 9 patients had orbit disease.
  • 4 patients had liver disease.
  • 10 patients received radiation therapy.
  • 3 patients developed secondary osteosarcoma.

Sources:

  • I.J. Dunkel and colleagues, Memorial Sloan-Kettering Cancer Center, Department of Pediatrics. (2010) "Intensive multimodality therapy for patients with stage 4a metastatic retinoblastoma. Pediatric Blood & Cancer, 2010;55(1):55-9"
  • Retinoblastoma. (no date)
  • Cancer Weekly via NewsRx.com. (2010)