Chemotherapy may offer alternative to enucleation in certain retinoblastoma cases
A conservative approach can be considered as a safe alternative to primary enucleation in children with advanced retinoblastoma in some cases, according to a presenter.
“Chemotherapy with appropriate focal consolidation can help provide eye salvage in about 50% of children with advanced group E retinoblastoma with clinical high-risk factors and without increasing any risk to life,” Harika Regani, MD, said at the virtual American Academy of Ophthalmology annual meeting.
In a retrospective, observational case series, Regani and colleagues at Centre for Sight Super Specialty Eye Hospital in Hyderabad, India, investigated 85 eyes of 79 consecutive patients from March 2013 to January 2019 with group E retinoblastoma and associated clinical risk factors who had no prior treatment and were managed with primary neoadjuvant chemotherapy. Exclusion criteria included group E eyes with no clinical risk factors, optic nerve extension, orbital extension and metastasis at initial presentation.
Enucleation was necessary in 39 eyes (45% of patients), while 46 eyes (52% of patients) were salvaged. The mean number of sessions of overall treatment was comparable between the groups, Regani said. Among enucleated eyes, six had histopathological risk factors and required adjuvant chemotherapy.
At the mean follow-up of 26 months, no patients had systemic metastasis, and 22% had good vision possibilities, Regani said.