SUCCESSFUL TREATMENT WITH RANIMUSTINE AND CARBOPLATIN FOR RECURRENT INTRAOCULAR RETINOBLASTOMA WITH VITREOUS SEEDING

This is the first report of successful treatment of recurrent retinobl astoma with vitreous seeding by a combination of ranimustine (MCNU) an d carboplatin. The patient was diagnosed with bilateral retinoblastoma at 3 years of age. Although he received photocoagulation and radiothe rapy for the left eye after enucleation of the right eye, a recurrent tumor associated with vitreous seeding developed 6 years later. The ch ild underwent chemotherapy with cyclophosphamide and nimustine hydroch loride (ACNU), and a transient decrease of tumor cells in the vitreous was seen. We then changed the chemotherapy regimen to MCNU (70 mg/m(2 )/day for 1 day) and carboplatin (300 mg/m(2)/day for 2 days). After f ive courses of this chemotherapy, the tumor in the vitreous completely disappeared. No recurrence has been observed for >4 years. Side effec ts, including myelosuppression, general fatigue, and vomiting, were ob served during the course of chemotherapy, but they were ameliorated wi th supportive therapy. Neither nephro- nor ototoxicity was observed. T he patient has useful vision. These results warrant further study of t his novel drug combination in patients with recurrent, or even primary , retinoblastoma.