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Title: Outcomes of pediatric retinoblastoma treated with ICEV regimen: A single-center study
Authors: Jassada Buaboonnam
Nattee Narkbunnam
Nassawee Vathana
Chayamon Takpradit
Kamon Phuakpet
Bunchoo Pongtanakul
Sasima Tongsai
La Ongsri Atchaneeyasakul
Kleebsabai Sanpakit
Faculty of Medicine, Siriraj Hospital, Mahidol University
Keywords: Medicine
Issue Date: 17-Feb-2019
Citation: Pediatric Hematology and Oncology. Vol.36, No.2 (2019), 73-81
Abstract: © 2019, © 2019 Taylor & Francis Group, LLC. Retinoblastoma is the most common intraocular malignancy in children. The aim of this study was to investigate the efficacy and toxicity of combination ifosfamide, carboplatin, etoposide, and vincristine (ICEV) in advanced-stage pediatric retinoblastoma [International Classification of Retinoblastoma (ICRB) group D or E], and in ICRB group C in the second eye in simultaneously treated bilateral retinoblastoma. The medical records of retinoblastoma patients treated with concurrent ICEV regimen and focal therapy were retrospectively reviewed. The ICEV treatment protocol was, as follows: ifosfamide 1800 mg/m2 on Days 1–3; MESNA 600 mg/m2 on Days 1–3; carboplatin 560 mg/m2 on Day 1; etoposide 150 mg/m2 on Days 1–3; and vincristine 1.5 mg/m2 on Day 1. Of 16 retinoblastoma patients, 13 had bilateral disease. Seven first eyes in bilateral disease that were enucleated prior to ICEV therapy were excluded. Twenty-two eyes were finally included (six group C, six group D, and ten group E). Median follow-up was 3.4 years, and the median number of ICEV courses was 7. Fifteen globes could be salvaged, 12 responded to ICEV (six group C, five group D, and one group E), and three unresponsive eyes could be salvaged with external beam radiation therapy (EBRT). Enucleation-free and relapse-free survival was 68.2 and 54.5%, respectively. The results of this study suggest ICEV as an alternative therapeutic approach for globe salvage in pediatric retinoblastoma, especially in ICRB groups C and D with manageable acute toxicity. Further study in larger cohort is needed to confirm the effectiveness of treatment.
ISSN: 15210669
Appears in Collections:Scopus 2019

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