Neoadjuvant Carboplatin and Vincristine and Standard Local Ophthalmic Therapy in Treating Patients With Intraocular Retinoblastoma

Inclusion Criteria

• •Newly diagnosed Group B intraocular retinoblastoma meeting 1 of the following criteria:
• •* Group B tumor(s) in 1 eye
• •* Group B tumor(s) in both eyes
• •* Group A tumor in 1 eye and Group B tumor(s) in the other eye
• •* Group E tumor in 1 eye that has been enucleated and Group B tumor(s) in the remaining eye at the time of enucleation of the Group E tumor
• •Defined by the International Classification System for Intraocular Retinoblastoma as follows:
• •* Group A: Small tumors (≤ 3 mm in greatest dimension) confined to the retina, away from foveola and disc meeting the following criteria:
• •* More than 3 mm from fovea
• •* More than 1.5 mm from optic disk
• •* Group B: Tumors more than 3 mm meeting the following criteria:
• •* Confined to the retina in any location not in Group A
• •* Tumor associated subretinal fluid \< 3 mm from the tumor margin with no subretinal seeding
• •* Group E: Must have ≥ 1 of the following present:
• •* Tumor touching the lens
• •* Tumor anterior to anterior vitreous face involving ciliary body or anterior segment
• •* Diffuse infiltrating retinoblastoma
• •* Neovascular glaucoma
• •* Opaque media from hemorrhage
• •* Tumor necrosis with aseptic orbital cellulites
• •* Phthisis bulbi
• •Confirmation of diagnosis by CT scan or MRI of the brain and orbits AND an ophthalmologic evaluation under anesthesia within the past 3 weeks
• •No choroidal and/or optic nerve invasion past the lamina cribosa
• •No evidence of extraocular retinoblastoma clinically or by head and orbital MRI and/or CT scan
• •No tumor present on histological exam at the cut end of the optic nerve for any Group E eye enucleated before study entry
• •Performance status - ECOG 0-2
• •Bilirubin ≤ 1.5 times upper limit of normal (ULN) for age
• •AST or ALT \< 2.5 times ULN for age
• •Creatinine clearance (based on Schwartz formula) or radioisotope glomerular filtration rate ≥ 70mL/min/1.73 m\^2
• •No prior chemotherapy
• •No other concurrent chemotherapy
• •No prior radiotherapy
• •No other concurrent radiotherapy, including intensity-modulated stereotactic, or proton beam radiotherapy
• •Prior enucleation of one eye allowed provided the remaining eye is Group B
• •No concurrent enucleation
• •No prior local ophthalmic therapy for retinoblastoma
• •No other prior therapy for retinoblastoma
• •No local therapy during chemotherapy course 1