Retinoblastoma in initial stages. Clinical experience at the Instituto Nacional de Pediatria [RETINOBLASTOMA EN ESTADIOS INICIALES. EXPERIENCIA CLINICA EN EL INSTITUTO NACIONAL DE PEDIATRIA]
Por:
Leal C.A., Rivera-Luna R., Martinez A., Cardenas R.S., Salazar A., Lanche M.T., Ridaura S.C.
Publicada:
1 ene 1995
Resumen:
Retinoblastoma is the most frequent malignant solid tumor diagnosed at the Instituto Nacional de Pediatria, a third level hospital and a referral center for children diseases in Mexico City. Although, a small percentage of this tumor are diagnosed in early stages or with disease limited to the retina. During the period 1973 to 1993 a total of 412 patients with retinoblastoma were treated in our hospital. Of these, only 35 patients (12%) were classified as stage I according to the Pratt clinical-pathological system staging. Fifteen patients (43%) were men and 20 women (57%) with a mean age of 27 months (range 1-156 months). Twenty-one patients (60%) live in urban areas, and 14 (40%) in rural zones. The mean time before the diagnosis of retinoblastoma was five months. Retinoblastoma unilateral eye involvement was detected in 29 patients (83%), and in six (17%) the tumor affected both eyes. The patients with unilateral eye affection were treated as follows: a) eye enucleation 38%; b) eye enucleation plus chemotherapy 48%; and c) eye enucleation plus chemotherapy and radiotherapy to the orbit 14%. After a follow up of four to 180 months (mean 6.9 years) the 29 patients with unilateral retinoblastoma are alive. The six patients with bilateral disease were treated with enucleation of the most affected eye followed by alternated cycles of chemotherapy and radiotherapy in the preserved eye. The chemotherapy scheme consisted of vincristine + cyclophosphamide alternated with vincristine-adriamycin. Of the six patients, five are alive after a follow up of 18 to 120 months, the remaining patient was lost to the follow up with tumoral activity. The main objective of the study is to describe the clinical experience with a group of 35 patients with stage I retinoblastoma, collected during 20 years. Also we propose a new classification for the staging of early retinoblastoma.
Filiaciones:
Leal C.A.:
Instituto Nacional de Pediatria, Departamento de Oncologia, Insurgentes Sur 3700-C, 04530 Mexico, D.F., Mexico
Rivera-Luna R.:
Instituto Nacional de Pediatria, Departamento de Oncologia, Insurgentes Sur 3700-C, 04530 Mexico, D.F., Mexico
Martinez A.:
Instituto Nacional de Pediatria, Departamento de Oncologia, Insurgentes Sur 3700-C, 04530 Mexico, D.F., Mexico
Cardenas R.S.:
Instituto Nacional de Pediatria, Departamento de Oncologia, Insurgentes Sur 3700-C, 04530 Mexico, D.F., Mexico
Salazar A.:
Instituto Nacional de Pediatria, Departamento de Oncologia, Insurgentes Sur 3700-C, 04530 Mexico, D.F., Mexico
Lanche M.T.:
Instituto Nacional de Pediatria, Departamento de Oncologia, Insurgentes Sur 3700-C, 04530 Mexico, D.F., Mexico
Ridaura S.C.:
Instituto Nacional de Pediatria, Departamento de Oncologia, Insurgentes Sur 3700-C, 04530 Mexico, D.F., Mexico
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