9538 Background: intraocular retinoblastoma treatments often associate chemotherapy and focal treatments. The protocols vary and may combine two or three drugs, and different number of cycles associated to the local adjuvant treatments. A first prospective protocol of conservative treatments in our institution showed the efficacy of the use of two courses of chemoreduction with etoposide and carboplatin, followed by chemothermotherapy using carboplatin, as a single agent. In order to decrease the possible long term toxicity of chemotherapy due to etoposide, a prospective randomized phase II chemo reduction protocol was conducted, using vincristine and carboplatin vs. etoposide carboplatin. Methods: the study was proposed when initial tumour size or location did not allow the use of front-line local treatments. The phase II randomized study of reduction chemotherapy used vincristin carboplatin or etoposide carboplatin, followed by local treatment including chemothermotherapy using the combination carboplatin and laser diode hyperthermia. Primary endpoint was the need for secondary enucleation or EBRT not exceeding 40% at 2 years. The new treatment was considered sufficiently effective if 10 events or less were observed among 33 eyes. Results: 55 children, 65 eyes were included in the study (May 2004- August 2009).32 eyes (27 children) were treated conservatively in the arm etoposide-carboplatin and 33 (28 children) eyes in the arm vincristin carboplatin.At two years after treatment 23/33 (69.7%) eyes were treated and salvaged without EBRT or enucleation in the arm vincristin-carboplatin and 26/32 (81.3%) in the arm etoposide and carboplatin. Conclusions: neoadjuvant chemotherapy by two cycles of vincristine and carboplatin followed by chemothermotherapy (using the combination carboplatin, as a single drug, and laser diode hyperthermia) does not seem to offer an optimal local control.
Neoadjuvant Chemotherapy and Radical Surgery Versus Exclusive Radiotherapy in Locally Advanced Squamous Cell Cervical Cancer: Results From the Italian Multicenter Randomized Study