{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T23:16:07Z","timestamp":1789859767059,"version":"4.0.1"},"reference-count":41,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCO"],"published-print":{"date-parts":[[2000,1,1]]},"abstract":"<jats:p> PURPOSE: To study the effectiveness of combined systemic chemotherapy and local ophthalmic therapy for retinoblastoma with the goal of avoiding enucleation and external-beam radiation therapy (EBRT). <\/jats:p><jats:p> PATIENTS AND METHODS: This was a prospective, nonrandomized, single-arm clinical trial. Seventy-five eyes were followed in 47 children. Patients were treated with a six-cycle protocol of vincristine, etoposide, and carboplatin. Most (83%) also received ophthalmic treatment (cryotherapy, laser photocoagulation, thermotherapy, or plaque radiation therapy) during and\/or after the chemotherapy. <\/jats:p><jats:p> RESULTS: With a median follow-up of 13 months, event-free survival was 74%, with an event defined as enucleation and\/or EBRT. Six children required EBRT in seven eyes (9%); five required enucleation of one eye (7%); five required a combination of EBRT and enucleation in six eyes (8%). Reese-Ellsworth groups 1, 2, and 3 eyes had excellent results, with avoidance of EBRT or enucleation in all 39. Treatment of groups 4 and 5 was less successful, with 33% of six eyes and 53% of 30 eyes, respectively, requiring EBRT and\/or enucleation. Toxicities from chemotherapy were mild and included cytopenias (89%), fever and neutropenia (28%), infection (9%), and gastrointestinal symptoms, dehydration, and vincristine neurotoxicity (40%). No patients developed a second malignancy, metastatic disease, renal disease, or ototoxicity. <\/jats:p><jats:p> CONCLUSION: In retinoblastoma patients with Reese-Ellsworth eye groups 1, 2, or 3, systemic chemotherapy used with local ophthalmic therapies can eliminate the need for enucleation or EBRT without significant systemic toxicity. More effective therapy is required for Reese-Ellsworth eye groups 4 and 5. <\/jats:p>","DOI":"10.1200\/jco.2000.18.1.12","type":"journal-article","created":{"date-parts":[[2017,2,24]],"date-time":"2017-02-24T09:21:04Z","timestamp":1487928064000},"page":"12-12","source":"Crossref","is-referenced-by-count":189,"title":["Chemoreduction and  Local Ophthalmic Therapy for  Intraocular  Retinoblastoma"],"prefix":"10.1200","volume":"18","author":[{"given":"Debra L.","family":"Friedman","sequence":"first","affiliation":[{"name":"From  the Department of PediatricsDivision of Oncology, The Children\u2019s  Hospital of Philadelphia; University of Pennsylvania, Philadelphia PA; and  Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University,  Philadelphia  PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce","family":"Himelstein","sequence":"additional","affiliation":[{"name":"From  the Department of PediatricsDivision of Oncology, The Children\u2019s  Hospital of Philadelphia; University of Pennsylvania, Philadelphia PA; and  Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University,  Philadelphia  PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol L.","family":"Shields","sequence":"additional","affiliation":[{"name":"From  the Department of PediatricsDivision of Oncology, The Children\u2019s  Hospital of Philadelphia; University of Pennsylvania, Philadelphia PA; and  Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University,  Philadelphia  PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerry A.","family":"Shields","sequence":"additional","affiliation":[{"name":"From  the Department of PediatricsDivision of Oncology, The Children\u2019s  Hospital of Philadelphia; University of Pennsylvania, Philadelphia PA; and  Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University,  Philadelphia  PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Needle","sequence":"additional","affiliation":[{"name":"From  the Department of PediatricsDivision of Oncology, The Children\u2019s  Hospital of Philadelphia; University of Pennsylvania, Philadelphia PA; and  Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University,  Philadelphia  PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Miller","sequence":"additional","affiliation":[{"name":"From  the Department of PediatricsDivision of Oncology, The Children\u2019s  Hospital of Philadelphia; University of Pennsylvania, Philadelphia PA; and  Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University,  Philadelphia  PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greta R.","family":"Bunin","sequence":"additional","affiliation":[{"name":"From  the Department of PediatricsDivision of Oncology, The Children\u2019s  Hospital of Philadelphia; University of Pennsylvania, Philadelphia PA; and  Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University,  Philadelphia  PA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna T.","family":"Meadows","sequence":"additional","affiliation":[{"name":"From  the Department of PediatricsDivision of Oncology, The Children\u2019s  Hospital of Philadelphia; University of Pennsylvania, Philadelphia PA; and  Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University,  Philadelphia  PA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"R1-0021","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.2910420408"},{"key":"R2-0021","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.1980.01020040056003"},{"key":"R3-0021","doi-asserted-by":"crossref","unstructured":"Shields   CL,   Shields   JA:   Recent developments in  the management of retinoblastoma.  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