Results of a stage-based protocol for the treatment of retinoblastoma.

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Abstract
PURPOSETo describe the treatment of retinoblastoma at a single institution using a prospective protocol based on histopathologic staging.PATIENTS AND METHODSWe included 116 consecutive patients (101 eligible, 46 bilateral) from August 1987 to December 1993. Treatment was enucleation or conservative therapy for intraocular disease (stage I patients). Stage II patients (orbital or postlaminar invasion) received vincristine, cyclophosphamide, and doxorubicin for 57 weeks. Patients with orbital mass and extension beyond the cut end of the optic nerve also received orbital radiotherapy (45 Gy). The latter received intrathecal therapy. In those with CNS (stage III) or hematogenous metastasis (stage IV), cisplatin and etoposide were added along with cranial (in patients with a CNS mass and prophylactically in stage IV) or craniospinal (in patients with positive CSF) radiotherapy.RESULTSThe median follow-up time was 39 months (range, 12 to 84). The overall survival rate was 0.84. Survival rates according to stage...

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