Program Book

(follow-up 5 years). Two years after PT, the adult patient had a
recurrent tumor that was controlled by brachytherapy. Proton therapy
of the orbit in very young patients leads to bad cosmetic Results and
should be avoided.
Conclusions. Further efforts are necessary to find techniques that can
be applied in very young children unable to collaborate. The technique
has to include positioning without using ionizing radiation. In principle,
a dose distribution limited to the eye and not damaging the growing
bones can be achieved using two fields and an isocentric gantry.
Financial disclosure. None
52 RBp133
MULTIPLE PLAQUE TREATMENT IN RETINOBLASTOMA
Manoj Parulekar, Randhir Chavan, John Ainsworth, Helen Jenkinson, Dan
Ford, David Spooner, Geoff Heyes (manojparulekar@aol.com)
Birmingham Children’s Hospital, and University Hospitals Birmingham, UK
Purpose. 106 Ruthenium plaque brachytherapy is a useful tool in salvage
treatment of retinoblastoma with limited lateral irradiation and ease of
use. To determine the safety and efficacy of multiple 106 Ruthenium
plaque treatment for eyes with persistent or recurrent retinoblastoma.
Methods. Retrospective review of all children treated in a single
retinoblastoma centre over an eight year period (2002-2010).
Results. 26 tumours in 21 eyes required brachytherapy as salvage
treatment. 11.5mm (65%), 15.5mm (23%) and notched (12%) plaques
were used. 52% tumours regressed after application of one plaque,
and 25% required a further plaque to control disease. Although some
radiation related complications were noted in the 5 eyes receiving more
than one plaque, 4 of these eyes were salvaged with useful vision (
mean visual acuity 0.6 logMAR).
Conclusions. The main aim of salvaging eyes was achieved in most
cases treated with multiple plaques. Despite the risk of complications,
this high risk strategy might be suitable is some cases to avoid
enucleation.
Financial disclosure. None
2301 RBp134
ASSESSMENT OF POST-OPERATIVE VOMITING IN
RETINOBLASTOMA PATIENTS AND THEIR SIBLINGS
UNDERGOING EYE EXAMS UNDER ANESTHESIA
Pascal Owusu-Agyemang, Elizabeth Rebllo, Radha Arunkumar, Joseph
Ruiz, Dan Gombos (poagyemang@mdanderson.org)
University of Texas M.D. Anderson Cancer Center; Retinoblastoma Center
of Houston
Purpose. To evaluate the incidence of emesis in the PACU in pediatric
patients undergoing eye exams of minimal stimulation under
anesthesia.
Methods. We analyzed data from ophthalmologic procedures that
did not involve a surgical incision, laser, and cryotherapy from our
Automated Anesthesia Information System. Between January 2006 and
July 2010 we found 76 patients with a diagnosis of or need for screening
for retinoblastoma. Our endpoint was administration of an antiemetic
or the documentation of emesis in the PACU. Descriptive statistics were
used in data analysis.
Results. Sixty-three percent of patients received prophylactic antiemetics:
40/76 (53%) received ondansetron alone, 6/76(8 %) received
RETINOBLASTOMA
Posters
58
both ondansetron and dexamethasone, and 2/76 (2.6%) patients
received dexamethasone alone. The overall incidence of emesis in this
study group was 1.3% (1/76 patients). The incidence of emesis in the
group of patients receiving anti-emetics and those not receiving antiemetics
was 0% and 3% respectively.
Conclusions. In our study where identified risk factors were present
but with essentially no surgical stimulation the incidence of POV in the
PACU was lower than the baseline of 9% with no risk factors2. However,
the discomfort associated with POV may justify prophylactic anti-emetic
administration.
Financial disclosure. None
120 RBp135
MANAGEMENT OF AN ECTOPIC SELLAR TRILATERAL
RETINOBLASTOMA
Rana’a Al-Jamal, Sanna Seitsonen, Ulla Pihkala, Matti Tenhunen, Päivi
Lindahl, Leena Koskinen, Tero Kivelä (ranaa.aljamal@hus.fi)
Departments of Ophthalmology, Paediatrics and Oncology, Helsinki
University Central Hospital, Helsinki, Finland
Purpose. To report successful management of an ectopic sellar
trilateral retinoblastoma.
Methods. A 10-month-old girl with strabismus and leukokoria had
bilateral retinoblastoma (Group E, OD; group D, OS). MRI revealed an
enhancing 20x24 mm sellar tumour which protruded to the suprasellar
cistern and pushed the chiasm. Spinal MRI, bone marrow aspirate and
lumbar puncture revealed no metastases.
Results. Combination chemotherapy was started eight days after
diagnosis.
The 1st, 3rd and 5th cycles consisted of intravenous topotecan (2 mg/
m2 on days 1 and 2), cisplatin (120 mg/m2 on day 1), vincristine (2 mg/
m2 on day 3) and intrathecal thiotepa (5 mg on day 5). In the 2nd cycle,
cisplatin was substituted with carboplatin (560 mg/m2 on day 1) and
the 4th cycle consisted of vincristine, topotecan and thiotepa.
The intraocular tumours responded promptly and were consolidated
with TTT. Before the 2nd cycle, she underwent autologous
hematopoietic stem cell harvesting. Stem cell rescue was executed at
5 and 7 months, preceded by high dose chemotherapy (carboplatin
500 mg/m2, thiotepa 300 mg/m2, and topotecan 2 mg/m2 on days
1-3). Stereotactic radiotherapy was given between the stem cell
transplantations (6 MV photons, 1.8 Gy fraction size, 17 fractions) from
a linear accelerator (30.6 Gy) from five conformal dynamic fields.
Latest brain and spinal MRI 3 years after termination of treatment show
full regression. Binocular VA is 20/40. She receives growth hormone,
thyroxine and hydrocortisone substitution.
Conclusions. The patient is one of three known longer term survivors
after an ectopic sellar trilateral retinoblastoma.
Financial disclosure. None
350 RBp136
MOLECULAR PATHWAYS OF RETINOBLASTOMA RE-
VEALED THROUGH GLOBAL PROTEOMICS ANALYSES
OF Y79 AND CHLA215 CELL LINES: A DRUG RESIS-
TANCE CASE STUDY
Susan Lee1,2, Robert Fanter1, Narine Harutyunyan1, Joanne Lee1, A Linn
Murphree1,3 (sulee@chla.usc.edu)