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Intravenous Chemotherapy for Retinoblastoma: A Pediatric Oncologist’s Perspective

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Global Perspectives in Ocular Oncology

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Abstract

Intravenous chemotherapy is available as a treatment modality in 98% of retinoblastoma centers surveyed worldwide. The most common regimen used is carboplatin, etoposide, and vincristine (CEV). This regimen is efficacious when used as chemoreduction (a neoadjuvant strategy to shrink intraocular tumors) as well as in the adjuvant setting post-enucleation and to treat orbital disease when combined with surgery and radiation therapy.

Concerns raised about systemic chemotherapy include the risk of secondary leukemia, hearing loss, and sterility. In a recent study of 523 patients, there were no cases of secondary leukemia in patients treated with CEV with one case in a patient treated with CEV and radiation therapy. Regarding hearing loss, studies of over 300 European and Philadelphian treated patients showed a 1% incidence of hearing loss with standard dose CEV and normal hearing established at treatment outset. Lastly, CEV does not cause infertility. Febrile neutropenia is expected in approximately 10% of patients with allergic reactions in 5%.

This chapter describes when and how to administer appropriate systemic chemotherapy critical to saving the life and preserving as much vision as possible in children with retinoblastoma worldwide.

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Authors and Affiliations

  1. Perelman School of Medicine at the University of Pennsylvania and the Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Amish Shah & Ann M. Leahey

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  1. Amish Shah
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  2. Ann M. Leahey
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Correspondence to Ann M. Leahey .

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Editors and Affiliations

  1. Ocular Oncology Service Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India

    Bhavna V. Chawla

  2. Retina Service Massachusetts Eye and Ear Harvard Medical School, Boston, MA, USA

    Mary E. Aronow

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Shah, A., Leahey, A.M. (2022). Intravenous Chemotherapy for Retinoblastoma: A Pediatric Oncologist’s Perspective. In: Chawla, B.V., Aronow, M.E. (eds) Global Perspectives in Ocular Oncology. Springer, Cham. https://doi.org/10.1007/978-3-031-08250-4_6

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