{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T17:29:04Z","timestamp":1790530144409,"version":"4.1.0"},"reference-count":15,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2010,4,1]],"date-time":"2010-04-01T00:00:00Z","timestamp":1270080000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2010,7,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>We previously reported promising pilot results treating patients with stage 4a metastatic retinoblastoma with combined intensive conventional chemotherapy, high\u2010dose chemotherapy with autologous hematopoietic stem cell rescue, and radiation therapy and now present an expanded and updated series.<\/jats:p><\/jats:sec><jats:sec><jats:title>Procedure<\/jats:title><jats:p>Fifteen patients with bone marrow (n\u2009=\u200914), bone (n\u2009=\u200910), orbit (n\u2009=\u20099), and\/or liver (n\u2009=\u20094) disease were treated. Induction chemotherapy usually consisted of vincristine, cyclophosphamide, cisplatin, and etoposide. The high\u2010dose chemotherapy regimen included carboplatin and thiotepa alone (n\u2009=\u20091) or with etoposide (n\u2009=\u20095) or topotecan (n\u2009=\u20097).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Bone marrow cleared at first post\u2010initiation of chemotherapy examination in all patients and stem cells were harvested after a median of 3.5 cycles of chemotherapy (range 3\u20136 cycles). Two patients progressed prior to high\u2010dose chemotherapy and died. Thirteen received high\u2010dose chemotherapy at a median of 6 months post\u2010diagnosis of metastases (range 4\u20138 months). Ten are retinoblastoma\u2010free in first remission at a median follow\u2010up of 103 months (range 34\u2013202 months) while three recurred (two in the CNS, one in the mandible) 14\u201320 months post\u2010diagnosis of metastases. Retinoblastoma\u2010free and event\u2010free survival at 5 years are 67% (95% confidence interval 38\u201385%) and 59% (95% confidence interval 31\u201379%). Six of the 10 survivors received radiation therapy. Three patients developed secondary osteosarcoma 14, 4, and 9 years after diagnosis of metastatic disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Intensive multimodality therapy including high\u2010dose chemotherapy with autologous hematopoietic stem cell rescue was curative for the majority of patients with stage 4a metastatic retinoblastoma treated. The contribution of external beam radiation therapy is unclear. Pediatr Blood Cancer 2010;55:55\u201359. \u00a9 2010 Wiley\u2010Liss, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.22504","type":"journal-article","created":{"date-parts":[[2010,4,1]],"date-time":"2010-04-01T14:37:42Z","timestamp":1270132662000},"page":"55-59","source":"Crossref","is-referenced-by-count":76,"title":["Intensive multimodality therapy for patients with stage 4a metastatic retinoblastoma"],"prefix":"10.1002","volume":"55","author":[{"given":"Ira J.","family":"Dunkel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasmin","family":"Khakoo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy A.","family":"Kernan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Gershon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Gilheeney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David C.","family":"Lyden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne L.","family":"Wolden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Orjuela","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon L.","family":"Gardner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David H.","family":"Abramson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2010,4]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.20606"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(20001115)89:10<2117::AID-CNCR12>3.0.CO;2-9"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0959-8049(97)10019-3"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1703832"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(03)00258-6"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/00043426-200401000-00011"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1704882"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1998.16.1.210"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1989.7.11.1748"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1993.11.12.2314"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1703213"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/mpo.10249"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.11647"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.05.054"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.22336"}],"container-title":["Pediatric Blood &amp; Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fpbc.22504","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pbc.22504","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,8]],"date-time":"2023-10-08T00:14:38Z","timestamp":1696724078000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pbc.22504"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,4]]},"references-count":15,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2010,7,15]]}},"alternative-id":["10.1002\/pbc.22504"],"URL":"https:\/\/doi.org\/10.1002\/pbc.22504","archive":["Portico"],"relation":{},"ISSN":["1545-5009","1545-5017"],"issn-type":[{"value":"1545-5009","type":"print"},{"value":"1545-5017","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,4]]}}}