Efficacy of induction chemotherapy in XXXX , alone or combined with other adjuvant modalities.

@entity1 @entity5 @entity3003 @entity786 @entity2879 @entity1891 @entity995
BACKGROUND: There are not much data available on the use of newer antimetabolites as an initial treatment modality in @entity995 , or their effect on vitreous seedings and de novo foci, especially in the Indian subcontinent. METHODS: To evaluate the efficacy of newer agents as induction chemotherapy, 34 @entity5 in 22 eyes of 19 @entity1 with @entity995 were treated with 2 cycles of @entity3003 , @entity2879 , @entity1891 , and @entity786 ; each cycle was of 1 month duration. The @entity5 response was evaluated at 2 months and adjuvant salvage modalities (ie, cryotherapy, laser, and/or external beam radiotherapy) were added as needed. The cycles were continued and ophthalmoscopic and ultrasonographic monitorings were performed to determine further @entity5 response, @entity5 height regression, effect on vitreous seeds, and other ocular changes. RESULTS: Mean @entity5 height at presentation was 4.2 mm, which regressed to 2.61 mm at 6 months (P=0.000). The biggest @entity5 to respond was 12.5 mm, although smaller multiple @entity5 regressed better. Adjuvant modalities were used in 28 @entity5 foci in 16 eyes. A follow up of 6 to 24 months (mean, 12.8+/-6.21 months), showed complete regression in 12/34 @entity5 , partial regression in 15/34, stable disease in 6/34, and 1 @entity5 progressed despite all therapy. Results in all 6 eyes with vitreous seeds were most gratifying; at 1 year vitreous seeds disappeared in 4 eyes and showed complete calcification in 2. Fresh new lesions were not seen in any eye with complete response after the first 2 cycles of chemotherapy. Recurrences were nil and complications minor. CONCLUSIONS: The overall @entity5 response (complete and partial) of more than 80% indicates that chemoreduction is an effective modality alone and combined with adjuvant salvage modalities. The results with our treatment regime, even in cases with @entity995 , are encouraging.
