External beam irradiation for retinoblastoma: patterns of failure and dose-response analysis

Journal Article · Wed Mar 01 04:00:00 EST 1989 · Int. J. Radiat. Oncol., Biol. Phys.; (United States)

DOI:https://doi.org/10.1016/0360-3016(89)90502-6· OSTI ID:6172603

Foote, R L; Garretson, B R; Schomberg, P J; Buskirk, S J; Robertson, D M; Earle, J D

Eighteen children with retinoblastoma (25 eyes) were treated with external beam radiation at the Mayo Clinic between January 1977 and January 1987; 15 eyes were in groups I to III and 10 were in groups IV and V. The median number of tumors per eye was 3. Radiation therapy consisted of 4- or 6-MV photons. Doses varied from 39 to 51 Gy in 1.8- to 3.0-Gy fractions. Fourteen eyes were treated through lateral fields by anterior segment-sparing techniques, and 11 eyes were treated by an anterior approach with no attempt at anterior segment sparing. All patients survived (median follow-up, 31.5 months). Cataracts developed in five eyes at a median of 23 months, four in eyes treated with anterior segment-sparing techniques. Of the 15 group I to III eyes, 6 required additional treatment; 4 were salvaged with cryotherapy or photocoagulation and 2 were enucleated. Of the 10 group IV and V eyes, 8 required additional treatment; 4 were salvaged with cryotherapy or photocoagulation, 1 with persistent disease is being followed closely, and 3 were enucleated. Ten (71%) of the 14 eyes treated with anterior segment-sparing techniques required additional treatment. Four (36%) of the 11 eyes treated with an anterior approach required additional treatment. Ninety percent of the tumors 10 disc diameters or smaller (1 disc diameter = 1.6 mm) were controlled independently of dose and fractionation used when they were not in the low-dose area of the anterior retina of an eye treated with an anterior segment-sparing technique. We find that use of lateral, anterior segment-sparing techniques has a high risk of anterior retinal tumor development and cataract formation and should be abandoned in favor of techniques that treat the entire retina.

• Research Organization: Mayo Clinic, Rochester, MN (USA)
• OSTI ID: 6172603
• Journal Information: Int. J. Radiat. Oncol., Biol. Phys.; (United States), Journal Name: Int. J. Radiat. Oncol., Biol. Phys.; (United States) Vol. 16:3; ISSN IOBPD
• Country of Publication: United States
• Language: English

Related Subjects

550603* -- Medicine-- External Radiation in Therapy-- (1980-)
62 RADIOLOGY AND NUCLEAR MEDICINE
AGE GROUPS
BODY
BODY AREAS
CHILDREN
DISEASES
DOSE-RESPONSE RELATIONSHIPS
DOSES
ELEMENTARY PARTICLES
EYES
FACE
FRACTIONATED IRRADIATION
HEAD
IRRADIATION
IRRADIATION PROCEDURES
MASSLESS PARTICLES
MEDICINE
NEOPLASMS
NUCLEAR MEDICINE
ORGANS
PATIENTS
PHOTONS
RADIATION DOSES
RADIOLOGY
RADIOTHERAPY
RETINA
SENSE ORGANS
THERAPY