• Pre- and postconception factors associated with sporadic heritable and nonheritable retinoblastoma.

• Management of massive orbital involvement of intraocular retinoblastoma.

• Lack of response to chemoreduction in presumed well differentiated retinoblastoma.

• Three dimensional ultrasound of retinoblastoma: initial experience.

• Multiple anterior chamber cystic lesions as the first sign of advanced retinoblastoma.

1
UI - 2790788
AU - Bunin GR; Meadows AT; Emanuel BS; Buckley JD; Woods WG; Hammond GD
TI - Pre- and postconception factors associated with sporadic heritable and nonheritable retinoblastoma.
SO - Cancer Res 1989 Oct 15;49(20):5730-5
AD - Children's Hospital, Philadelphia, Pennsylvania.
A matched case-control study of retinoblastoma was conducted by the Children's Cancer Study Group (CCSG) to investigate the hypotheses that postconception exposures affect the risk of the nonheritable (post-zygotic origin) form of this disease and that preconception exposures affect the risk of the sporadic heritable (prezygotic origin) form. Eligible cases were those patients with retinoblastoma diagnosed in 1982-1985 at any of the CCSG member hospitals. Cases were classified as familial heritable, sporadic heritable, or nonheritable based on family history, tumor laterality, and cytogenetic analysis. Telephone interviews of parents of 201 cases and their pair-matched controls selected by random digit dialing were completed. Analysis of possible risk factors for the 67 sporadic heritable cases and the 115 nonheritable cases was performed. (The 19 familial cases were excluded). For the nonheritable group, gestational exposure to X-ray [odds ratio (OR) = 2.3, P = 0.08] and morning sickness medication (OR = 2.8, P = 0.02) and low maternal educational level (OR = 5.5, P = 0.03) were associated with increased risk; anemia (OR = 0.3, P = 0.02) and multivitamin use (OR = 0.4, P = 0.03) during pregnancy and periconceptional use of barrier contraceptive (OR = 0.1, P = 0.02) or spermicide (OR = 0.2, P = 0.02) were associated with decreased risk. In the sporadic heritable group, observations included a negative association with multivitamins during pregnancy (OR = 0.2, P = 0.02) and nonsignificant positive associations with preconception gonadal X-ray (maternal, OR = 2.0, P = 0.30; paternal, OR = 1.8, P = 0.42) and older parental age (case-control difference 1.0-1.2 years, P = 0.24-0.27). Many of the associations support study hypotheses, although the possibility of recall bias and chance findings suggest cautious interpretation.

2
UI - 9479294
AU - Kiratli H; Bilgic S; Ozerdem U
TI - Management of massive orbital involvement of intraocular retinoblastoma.
SO - Ophthalmology 1998 Feb;105(2):322-6
AD - Department of Ophthalmology, Hacettepe University, School of Medicine, Ankara, Turkey.
OBJECTIVE: This study aimed to evaluate various combinations of therapeutic approaches in an attempt to improve the poor outcome of advanced cases of orbital involvement of intraocular retinoblastoma. DESIGN: The study design was a retrospective, uncontrolled descriptive case series of consecutive patients with massive orbital retinoblastoma treated and observed at a referral center. PARTICIPANTS: Sixteen patients with unilateral orbital involvement of intraocular retinoblastoma were studied. Eight patients had orbital involvement at initial presentation and eight children presented with orbital tumor after enucleation for intraocular retinoblastoma. Patients having microscopic evidence of tumor invasion at surgical section of the optic nerve and subsequently receiving other forms of treatment were not included in the study. INTERVENTION: Six patients had orbital exenteration followed by external beam radiation therapy (4600-6000 cGy in fractionated doses) and chemotherapy. Five patients received chemotherapy only. Three patients were treated by exenteration and chemotherapy, whereas two patients underwent radiation therapy and chemotherapy. MAIN OUTCOME MEASURES: Tumor regression monitored by clinical observations and imaging studies and patient survival was studied. RESULTS: The median follow-up was 22 months (range, 4-168 months). All forms of treatment caused satisfactory local and systemic tumor regression. Two children achieved a survival of more than 10 years. However, two patients in the exenteration followed by chemotherapy and radiation therapy group and one who received chemotherapy only had central nervous system metastases develop and died. Only one patient was lost to follow-up. CONCLUSION: Highly individualized aggressive treatment by combining radical surgery, chemotherapy, and external beam radiation therapy allowed most of the authors' patients to have longer survival and disease-free intervals than expected.

3
UI - 11911540
AU - Singh AD; Shields CL; Shields JA
TI - Lack of response to chemoreduction in presumed well differentiated retinoblastoma.
SO - J Pediatr Ophthalmol Strabismus 2002 Mar-Apr;39(2):107-9
AD - Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.

4
UI - 12234894
AU - Finger PT; Khoobehi A; Ponce-Contreras MR; Rocca DD; Garcia JP Jr
TI - Three dimensional ultrasound of retinoblastoma: initial experience.
SO - Br J Ophthalmol 2002 Oct;86(10):1136-8
AD - The New York Eye Cancer Center and New York University School of Medicine, New York City 10021, USA. pfinger@eyecaner.com
AIM: To use 3D ultrasonography (3DUS) for the diagnosis of retinoblastoma. METHODS: Five eyes of three children with retinoblastoma were evaluated using a commercially available computerised 3DUS system. Interactive sectioning of the stored and reconstructed 3D volumes were performed. 3DUS and histopathological findings were correlated after enucleation. RESULTS: 3DUS examination revealed characteristics consistent with retinoblastoma: endophytic mass, retinal detachment, intratumoural calcifications, and secondary orbital shadowing. Unlike 2D imaging, 3DUS allowed for analysis of the acquired and stored volumes. Rotation and sectioning of this volume allowed the discovery of new oblique and coronal views. For example, calcium related orbital shadows were seen as 3D volumes and (coronal) cross sections of the optic nerve were evaluated for evidence of intraneural invasion by retinoblastoma. CONCLUSION: This is the first reported series of patients examined with 3DUS imaging for retinoblastoma. This technique allowed for new oblique and coronal views of the tumour and optic nerve. The ability to retrospectively analyse the (scanned and stored) ocular volume facilitated patient care, teaching, tumour-volume analysis, and telemedicine.

5
UI - 12365923
AU - Puig JJ; Arrondo E; Garcia-Arumi J; Gil JJ; Huguet P; Calatayud M
TI - Multiple anterior chamber cystic lesions as the first sign of advanced retinoblastoma.
SO - Arch Ophthalmol 2002 Oct;120(10):1385-8
AD - Hospital Valle de Hebron, Departamento de Oftalmologia, Paseo Valle de Hebron 119-129, Barcelona 08035, Spain. 29213jpg@comb.es

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