ROLE OF CHEMOTHERAPY ALONE OR IN COMBINATION WITH HYPERTHERMIA IN THEPRIMARY-TREATMENT OF INTRAOCULAR RETINOBLASTOMA - PRELIMINARY-RESULTS

Background-The efficacy of the etoposide-carboplatin combination in ex traocular retinoblastoma is well known. This drug combination is there fore used in intraocular retinoblastoma, as primary reduction chemothe rapy, before local treatment. The use of carboplatin in combination wi th diode laser hyperthermia as local treatment (thermochemotherapy) ha s been recently described as a conservative approach avoiding external beam radiotherapy in posterior pole tumours. Methods-All patients wer e reviewed, who were treated for retinoblastoma at the Institut Curie between June 1994 and October 1995, in whom treatment included either reduction chemotherapy or thermochemotherapy or both modalities succes sively. 23 patients presenting with unilateral (three) or bilateral (2 0) intraocular retinoblastoma received neoadjuvant chemotherapy consis ting of two courses of etoposide 150 mg/m(2)/day and carboplatin 200 m g/m(2)/day for 3 days. 15 patients (17 eyes), eight of whom had alread y received neoadjuvant chemotherapy, were treated by thermochemotherap y. Results-Neoadjuvant chemotherapy: overall, seven eyes in seven pati ents could be treated conservatively, avoiding external beam irradiati on, with a median follow up of 14 months. Thermochemotherapy: external beam irradiation was avoided for 14 of the 17 eyes treated. Conclusio n-Integration of neoadjuvant chemotherapy and combined treatment with carboplatin and diode laser, into the therapeutic armamentarium for re tinoblastoma allows use of more aggressive treatments such as enucleat ion and external beam radiation.