Systemic Vincristine, Carboplatin, and Etoposide, Subtenon Carboplatin, and Local Ophthalmic Therapy in Treating Children With Intraocular Retinoblastoma

DISEASE CHARACTERISTICS:

• Diagnosis of bilateral retinoblastoma with at least 1 eye group C or D intraocular retinoblastoma by ophthalmologic examination, defined by the International Classification System for Intraocular Retinoblastoma as the following:

  • Group C: Discrete localized disease with minimal subretinal and/or vitreous seeding

    • Subretinal fluid, without prior or concurrent seeding, involving ≤ one quarter of the retina
    • Local fine vitreous seeding may be present close to discrete tumor
    • Local subretinal seeding < 3 mm from tumor

  • Group D: Diffuse disease with significant vitreous and/or subretinal seeding

    • Tumor(s) may be massive or diffuse
    • Subretinal fluid, without prior or concurrent seeding, involving up to total retinal detachment
    • Diffuse or massive vitreous disease may include "greasy" seeds or avascular tumor masses
    • Diffuse subretinal seeding may include subretinal plaques or tumor nodules
• Prior enucleation of 1 eye allowed provided the remaining eye is group C or D

• No tumor present on histologic examination at the cut end of the optic nerve on any eye enucleated prior to study entry

  • Evidence of choroidal and/or optic nerve invasion past the lumina cribrosa is allowed
• No extraocular retinoblastoma clinically or by MRI of brain and orbits with and without gadolinium or CT scan with and without contrast of brain and orbits
• No evidence of systemic metastases by bone marrow, lumbar puncture, bone scan, and/or any other additional test

PATIENT CHARACTERISTICS:

Age

• Under 18

Performance status

• Karnofsky 50-100% (over 16 years of age)
• Lansky 50-100% (16 and under)

Life expectancy

• Not specified

Hematopoietic

• Not specified

Hepatic

• Bilirubin ≤ 1.5 times upper limit of normal (ULN) for age
• AST and ALT < 2.5 times ULN for age

Renal

• Creatinine adjusted according to age as follows:

  • No greater than 0.4 mg/dL (≤ 5 months)
  • No greater than 0.5 mg/dL (6 months -11 months)
  • No greater than 0.6 mg/dL (1 year-23 months)
  • No greater than 0.8 mg/dL (2 years-5 years)
  • No greater than 1.0 mg/dL (6 years-9 years)
  • No greater than 1.2 mg/dL (10 years-12 years)
  • No greater than 1.4 mg/dL (13 years and over [female])
  • No greater than 1.5 mg/dL (13 years to 15 years [male])
  • No greater than 1.7 mg/dL (16 years and over [male]) OR
• Creatinine clearance or radioisotope glomerular filtration rate at least 70 mL/min/1.73m^2

Other

• Not pregnant or nursing
• Fertile patients must use effective contraception
• Negative pregnancy test in postmenarchal females

PRIOR CONCURRENT THERAPY:

Biologic therapy

• Not specified

Chemotherapy

• No prior chemotherapy
• No other concurrent chemotherapy

Endocrine therapy

• Not specified

Radiotherapy

• No prior radiotherapy
• No other concurrent radiotherapy

Surgery

• See Disease Characteristics