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Tumor Control and Comparison of 2 Techniques

Ingrid U. Scott, MD, MPH; Timothy G. Murray, MD; William J. Feuer, MS; Kurtis Van Quill; Arnold M. Markoe, MD, ScD; Stella Ling, MD; Daniel B. Roth, MD; Joan M. O'Brien, MD

Arch Ophthalmol. 1999;117:766-770.

Objective  To investigate eye conservation, local control, and complication rates among children with retinoblastoma treated with 2 different external beam radiotherapy (EBR) techniques.

Methods  Fifty-eight eyes in 42 patients received EBR as the primary treatment modality for retinoblastoma (median follow-up, 37 months). The EBR technique was relative lens-sparing (RLS) in 26 eyes and modified lateral beam (MLB) in 32 eyes. Both groups were comparable in Reese-Ellsworth retinoblastoma classification. If necessary, patients received focal salvage therapy.

Results  At 24 months, eye conservation rates were 88.5% and 89.1% among eyes treated with RLS and MLB, respectively (P=.40); tumor control rates without salvage therapy were 84.6% and 53.3% (P=.02), respectively. Among eyes with Reese-Ellsworth stage IV and V disease, eye conservation rates were 88% ± 8% and 83% ± 9% at 36 months in the RLS and MLB groups, respectively, and local tumor control rates were 81% ± 10% and 51% ± 12%. Percentages of eyes without cataract at 36 months were 83.1% and 63.0%, respectively (P=.40). Among patients observed for at least 18 months, midfacial hypoplasia developed in 38.5% and 29.4%, respectively (P=.70).

Conclusions  The EBR technique was associated with high eye conservation and local control rates. Salvage therapy was performed significantly less frequently in the RLS group compared with the MLB group, and complication rates in both groups were similar.

From the Department of Ophthalmology, Bascom Palmer Eye Institute (Drs Scott, Murray, and Roth and Mr Feuer), and the Department of Radiation Oncology (Drs Markoe and Ling), University of Miami School of Medicine, Miami, Fla; and the Department of Ophthalmology, University of California at San Francisco School of Medicine, San Francisco (Mr Van Quill and Dr O'Brien).

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