Subtenon carboplatin in the management of intraocular retinoblastoma

ABSTRACT

To evaluate the efficacy of subtenon carboplatin as an adjuvant to systemic chemotherapy in the management of intraocular retinoblastoma. This study was conducted as a randomized, double-masked clinical trial. A diagnosis of intraocular retinoblastoma was made based on clinical examination, ultrasonography and orbital CT-scanning. The greatest basal dimension of the tumors was estimated in disc diameter [DD] by indirect ophthalmoscopy. Tumor thickness was determined by ultrasonography. Each eye was assigned to one of 10 blocks based on tumor stage [Reese-Ellseworth classification] and randomly received systemic chemotherapy alone [control group] or systemic chemotherapy plus 20mg subtenon carboplatin [case group]. Indirect laser photocoagulation or cryotherapy was performed as additional treatment. The study included 35 tumors in 17 eyes of 14 patients [19 tumors in 8 eyes of the control group and 16 tumors in 9 eyes of the case group]. There was 57.22% and 61.73% decrease in tumor thickness in the control and case groups, respectively [P=0.12]. The decrease in greatest basal tumor dimension in the control group [47.32%] was not significantly different from that in the case group [38.80%]. One eye [12.5%] in the control group and 3 eyes [33.3%] in the case group were enucleated. Adjuvant subtenon carboplatin does not seem to increase the efficacy of systemic chemotherapy in the treatment of intraocular retinoblastoma