External Beam Radiation "Salvage" Therapy in Transgenic Murine Retinoblastoma | Pediatric Cancer | JAMA Ophthalmology | JAMA Network
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Laboratory Sciences
February 2004

External Beam Radiation "Salvage" Therapy in Transgenic Murine Retinoblastoma

Author Affiliations

From the Bascom Palmer Eye Institute, Department of Ophthalmology,University of Miami, Miami, Fla (Drs Sobrin, Murray, Scott, Wu, and Markoe,Mss Hayden and Cicciarelli, and Messrs Hernandez and Feuer); and the Departmentof Ophthalmology, University of California, San Francisco (Ms Fulton and DrO'Brien). The authors have no relevant financial interest in this article.

Arch Ophthalmol. 2004;122(2):251-257. doi:10.1001/archopht.122.2.251
Abstract

Objective  To determine the efficacy of low-dose "salvage" external beam radiationtherapy (EBRT) following failed subconjunctival carboplatin chemotherapy ina murine model of heritable retinoblastoma.

Methods  Eighty-four eyes from 8-week-old, simian virus 40, T-antigen–positivemice were treated with 6 serial subconjunctival carboplatin injections (100µg/25 µL). At 12 weeks of age, 64 eyes received EBRT for a totaldose of 480 (4.8 Gy), 1200 (12.0 Gy), 1560 (15.6 Gy), or 3000 (30.0 Gy) rad.Twenty eyes received no additional therapy following subconjunctival carboplatininjections. Ten eyes received a total dose EBRT of only 3000 rad. Eight eyesreceived subconjuctival injections of only an isotonic sodium chloride solution.Ten eyes served as untreated controls.

Main Outcome Measures  Eyes were enucleated at 20 weeks to assess the presence of tumor onhistopathological examination.

Results  Salvage therapy using low-dose EBRT was able to reestablish tumor controlin a dose-dependent manner. Increasing the EBRT dose to 3000 rad resultedin 100% tumor control. The dose-dependent curves were significantly differentbetween the treatment groups—EBRT alone vs salvage EBRT after receivingsubconjunctival carboplatin injections (P<.001).

Conclusion  Low-dose hyperfractionated salvage EBRT following failed primary subconjunctivalcarboplatin chemotherapy is efficacious in the treatment of retinoblastomain this animal model.

Clinical Relevance  Salvage EBRT using a reduced total radiation dose could be associatedwith a radiation-related treatment enhancement in pediatric retinoblastoma.

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