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Authors: Antoneli, CBG
Lopes, L. F.
Epelman, S.
Saba, L. M.
Erwenne, Clélia Maria [UNIFESP]
Novaes, P. E.
Bianchi, A.
Universidade Federal de São Paulo (UNIFESP)
Issue Date: 1-Jan-1995
Publisher: Harwood Acad Publ Gmbh, Taylor & Francis Group
Citation: International Journal Of Pediatric Hematology/oncology. Philadelphia: Harwood Acad Publ Gmbh, Taylor & Francis Group, v. 2, n. 3, p. 217-221, 1995.
Abstract: Between January 1986 and December 1990, 120 patients with retinoblastoma were admitted at A. C. Camargo Hospital. Among these, 32 (26.6%) were extraocular, (24 unilateral and 8 bilateral). The hereditary type was present in 9 patients and sporadic in 23. Fifteen patients had optical nerve involvement, 5 scleral vessel and 9 orbital. The cerebrospinal fluid was positive in 1, and bone marrow was positive in 2 patients. The mean time before referral was 6 months. Chemotherapy was administered to all cases after enucleation or eyelid biopsy. This comprised cisplatin, etoposide, cyclophosphamide, vincristine and adryamicin, and intrathecal methotrexate. External irradiation (45 Gy) was initiated after surgery in patients with optical nerve involvement and in patients with measurable disease after 3 cycles of chemotherapy. Twenty-six to 32 were evaluated for response. The exclusions criteria were patients that refused treatment, or patients who received one cycle of chemotherapy and were lost to follow-up, making the evaluation for response impossible to be assess. Among them, 8 are free of disease and off treatment, with median follow-up of 14.6 months; 1 is alive with localized disease, and 3 are lost to follow-up. Fourteen patients died of disease; the median time of relapse was 6 months (range 1 to 13 months). We conclude that whereas the current approach yields results similar to others, more aggressive combined chemotherapy is necessary for the improvement in the treatment of patients with advanced retinoblastoma. Late referral may be responsible for the high incidence of advanced cases.
ISSN: 1070-2903
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