Subtenon Carboplatin in the Management of Intraocular Retinoblastoma

Abstract

<!--[if gte mso 9]><xml> Normal 0 false false false MicrosoftInternetExplorer4 </xml><![endif]--><!--[if gte mso 9]><xml> </xml><![endif]--> <!--[if gte mso 10]> <style> /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} </style> <![endif]--> <p>PURPOSE: To evaluate the efficacy of adjuvant subtenon carboplatin in the management of intraocular retinoblastoma. METHODS: This study was conducted as a randomized, double-masked clinical trial. A diagnosis of intraocular retinoblastoma was made based on clinical examination, ultrasonography and orbital CT-scanning. The greatest basal dimension of the tumors was estimated in disc diameter (DD) by indirect ophthalmoscopy. Tumor thickness was determined by ultrasonography. Each eye was assigned to one of 10 blocks based on tumor stage (Reese-Ellsworth classification) and randomly received systemic chemotherapy alone (control group) or systemic chemotherapy plus 20mg subtenon carboplatin (case group). Indirect laser photocoagulation or cryotherapy was performed as additional treatment. RESULTS: The study included 35 tumors in 17 eyes of 14 patients (19 tumors in 8 eyes in the control group and 16 tumors in 9 eyes in the case group). There was 57.22% and 61.73% decrease in tumor thickness in the control and case groups, respectively. This difference was not statistically significant (P=0.12). The decrease in greatest basal tumor dimension in the control group (47.32%) was not significantly different from that in the case group (38.80%). One eye (12.5%) in the control group and 3 eyes (33.3%) in the case group were enucleated. CONCLUSION: Adjuvant subtenon carboplatin does not seem to increase the efficacy of systemic chemotherapy in the treatment of intraocular retinoblastoma.</p>