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2014 ; 90
(4
): 863-9
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Proton radiation therapy for the treatment of retinoblastoma
#MMPMID25227498
Mouw KW
; Sethi RV
; Yeap BY
; MacDonald SM
; Chen YL
; Tarbell NJ
; Yock TI
; Munzenrider JE
; Adams J
; Grabowski E
; Mukai S
; Shih HA
Int J Radiat Oncol Biol Phys
2014[Nov]; 90
(4
): 863-9
PMID25227498
show ga
PURPOSE: To investigate long-term disease and toxicity outcomes for pediatric
retinoblastoma patients treated with proton radiation therapy (PRT). METHODS AND
MATERIALS: This is a retrospective analysis of 49 retinoblastoma patients (60
eyes) treated with PRT between 1986 and 2012. RESULTS: The majority (84%) of
patients had bilateral disease, and nearly half (45%) had received prior
chemotherapy. At a median follow-up of 8 years (range, 1-24 years), no patients
died of retinoblastoma or developed metastatic disease. The post-PRT enucleation
rate was low (18%), especially in patients with early-stage disease (11% for
patients with International Classification for Intraocular Retinoblastoma [ICIR]
stage A-B disease vs 23% for patients with ICIR stage C-D disease). Post-PRT
ophthalmologic follow-up was available for 61% of the preserved eyes (30 of 49):
14 of 30 eyes (47%) had 20/40 visual acuity or better, 7 of 30 (23%) had moderate
visual acuity (20/40-20/600), and 9 of 30 (30%) had little or no useful vision
(worse than 20/600). Twelve of 60 treated eyes (20%) experienced a post-PRT event
requiring intervention, with cataracts the most common (4 eyes). No patients
developed an in-field second malignancy. CONCLUSIONS: Long-term follow-up of
retinoblastoma patients treated with PRT demonstrates that PRT can achieve high
local control rates, even in advanced cases, and many patients retain useful
vision in the treated eye. Treatment-related ocular side effects were uncommon,
and no radiation-associated malignancies were observed.
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