“Eight Drugs in One Day” Chemotherapy in a Nonfamilial Bilateral Retinoblastoma with Recurrent Cerebrospinal Fluid Metastases

Abstract

A case of bilateral retinoblastoma with recurrent cerebrospinal fluid (CSF) metastases is presented. The patient underwent left eye enucleation and received external beam radiotherapy to the right eye. A sequential combination chemotherapy, including cyclophosphamide, vincristine, carboplatin, and etoposide with intrathecal drug administration, was then adopted. During treatment a relapse within the central nervous system (CNS) occurred. The “8-in-1-day” chemotherapy, used in our department in medulbblastoma patients with CSF involvement was then considered. The patient received 8 total courses, each with intrathecal drug administration. No toxicity was experienced. The patient is alive and free from CSF metastases after a period of 48 months and has been in continuous complete remission (CCR)for 41 months. The authors conclude that the use of the “8-in-1” regimen is feasible and can be used in retinoblastoma patients with recurrent CSF metastases.

Key Words:

• central nervous system
• chemotherapy
• “8-in-1” retinoblastoma