PURPOSE: This study compares the long-term actuarial local control, eye conservation rate, survival, and ocular complications in children with retinoblastoma treated with two different external beam treatment techniques. METHODS AND MATERIALS: From 1979-1991, 182 eyes in 123 children (104 bilateral) received primary external beam radiation therapy. An anterior lens-sparing electron beam technique delivering 38 to 50 Gy in 2.5 Gy fractions was used in 67 eyes from 1979-1984 and a modified lateral beam technique, delivering 42 to 46 Gy in 2 Gy fractions, was used in 113 eyes from 1984-1991. These groups were balanced with respect to known prognostic variables. RESULTS: For Group I-III eyes, the 5- and 8-year local control was significantly improved using the modified lateral beam technique (84%) compared to (38%) using the anterior lens sparing technique (p < or = 0.0001). For Group IV-V eyes, the 5- and 8-year local control rates were not statistically different, despite a trend favoring the modified lateral beam technique. Survival endpoints including eye survival (no enucleation), cause-specific survival, and overall survival comparing the two treatment techniques were not significantly different. Overall, 22% of eyes developed cataracts. There was no difference between the two treatment groups in terms of cataract development. No eyes required enucleation for ocular complications. CONCLUSION: There is a significant improvement in local control using the modified lateral beam technique compared to an anterior lens-sparing approach for Group I-III eyes. However, there was no difference in survival end points between the two treatment techniques. The incidence of ocular complications using these two external beam techniques is acceptable.
PURPOSE: This study compares the long-term actuarial local control, eye conservation rate, survival, and ocular complications in children with retinoblastoma treated with two different external beam treatment techniques. METHODS AND MATERIALS: From 1979-1991, 182 eyes in 123 children (104 bilateral) received primary external beam radiation therapy. An anterior lens-sparing electron beam technique delivering 38 to 50 Gy in 2.5 Gy fractions was used in 67 eyes from 1979-1984 and a modified lateral beam technique, delivering 42 to 46 Gy in 2 Gy fractions, was used in 113 eyes from 1984-1991. These groups were balanced with respect to known prognostic variables. RESULTS: For Group I-III eyes, the 5- and 8-year local control was significantly improved using the modified lateral beam technique (84%) compared to (38%) using the anterior lens sparing technique (p < or = 0.0001). For Group IV-V eyes, the 5- and 8-year local control rates were not statistically different, despite a trend favoring the modified lateral beam technique. Survival endpoints including eye survival (no enucleation), cause-specific survival, and overall survival comparing the two treatment techniques were not significantly different. Overall, 22% of eyes developed cataracts. There was no difference between the two treatment groups in terms of cataract development. No eyes required enucleation for ocular complications. CONCLUSION: There is a significant improvement in local control using the modified lateral beam technique compared to an anterior lens-sparing approach for Group I-III eyes. However, there was no difference in survival end points between the two treatment techniques. The incidence of ocular complications using these two external beam techniques is acceptable.
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Authors: Kent W Mouw; Beow Y Yeap; Paul Caruso; Aaron Fay; Madhusmita Misra; Roshan V Sethi; Shannon M MacDonald; Yen-Lin Chen; Nancy J Tarbell; Torunn I Yock; Suzanne K Freitag; John E Munzenrider; Eric Grabowski; Michelle Katz; Karen Kuhlthau; Dawn DeCastro; Gena Heidary; Jessica Ciralsky; Shizuo Mukai; Helen A Shih Journal: Adv Radiat Oncol Date: 2017 Jan-Mar