Current Management Strategies for Intraocular Retinoblastoma

@article{Kim2012CurrentMS,
  title={Current Management Strategies for Intraocular Retinoblastoma},
  author={Jonathan W. Kim and David H. Abramson and Ira J. Dunkel},
  journal={Drugs},
  year={2012},
  volume={67},
  pages={2173-2185}
}
Survival rates for retinoblastoma patients have increased dramatically over the last century, with documented 5-year survival figures reaching 87–99% in developed countries. During the last decade, there has been a dramatic paradigm shift in the treatment approach for intraocular retinoblastoma, emphasising chemoreduction protocols and minimising the use of external beam radiation. The recognition of the increased risk for second non-ocular cancers with external beam radiation contributed to… 
Retinoblastoma: Treatment Options
TLDR
Current management approaches for intraocular retinoblastoma are summarized, emphasizing the clinical indications for intravenous chemotherapy, external beam radiation, brachytherapy, focal modalities, intra-arterial chemotherapy, and intravitreal injection of chemotherapy.
A review of the literature for intra-arterial chemotherapy used to treat retinoblastoma
TLDR
Selective intra-arterial chemotherapy for retinoblastoma has emerged in the last 7 years in the United States as a feasible, effective and minimally invasive treatment option.
Super selective ophthalmic artery delivery of chemotherapy for intraocular retinoblastoma: ‘chemosurgery’The first Stallard lecture
  • D. Abramson
  • Medicine
    British Journal of Ophthalmology
  • 2010
TLDR
It was recognised that some of these irradiated children subsequently went on and developed cancers outside the eye (called ‘second non-ocular cancers’), and Reese believed that these second cancers were an unfortunate complication of radiation alone, as they only developed in irradiatedChildren and in the field of radiation and after long latent periods.
Progress in Small Molecule Therapeutics for the Treatment of Retinoblastoma.
While mortality is low for intraocular retinoblastoma patients in the developed world who receive aggressive multimodal therapy, partial or full loss of vision occurs in approximately 50% of patients
The Efficacy of Alternate Systemic Intravenous Chemotherapy and Intra-Arterial Chemotherapy Approach for Eye Globe Salvage in Retinoblastoma.
TLDR
Primary IAC-IVC for patients with retinoblastoma was tolerable and effective in salvaging the eye and maintaining survival and examined its efficacy and safety in eye globe salvage in this study.
Risk Factors for Tumor Recurrence Following Primary Intravenous Chemotherapy (Chemoreduction) for Retinoblastoma in 869 Eyes of 551 Patients.
TLDR
Retinoblastoma recurrence after chemoreduction is usually detected within the first 3 years following treatment, but recurrence can often be managed with globe-sparing therapy.
Orbital fibrosis and intraocular recurrence of retinoblastoma following periocular carboplatin.
TLDR
A child with bilateral advanced retinoblastoma underwent six cycles of systemic chemotherapy and developed orbital scarring and intraocular tumor recurrence at the site of injection following treatment with periocular carboplatin.
Intra-arterial chemotherapy for retinoblastoma in eyes with vitreous and/or subretinal seeding: 2-year results
TLDR
Unlike radiation or systemic chemotherapy, intra-arterial chemotherapy can usually prevent the need for enucleation in naive eyes with advanced intraocular retinoblastoma with seeding—especially if the seeding is subretinal.
Diffuse anterior retinoblastoma: current concepts
TLDR
The most common treatment for diffuse anterior retinoblastoma is enucleation followed by systematic chemotherapy according to the patient’s presentation and clinical course and the challenges of early diagnosis and prospects are discussed.
Clinical course of retinoblastoma.
TLDR
Most children with Rb showed an advanced stage of tumour at the time of diagnosis and measures to improve the rate of globe preservation and patient survival by early diagnosis and intervention are the need of the hour.
...
...

References

SHOWING 1-10 OF 117 REFERENCES
Chemotherapy plus local treatment in the management of intraocular retinoblastoma.
TLDR
Thermochemotherapy is successful primary treatment for Reese-Ellsworth group 1 and 2 retinoblastomas and external beam radiotherapy can safely be avoided in the primary treatment of Reese- Ellsworth groups 1 through 4 nondispersed retinOBlastoma.
Combining cyclosporin with chemotherapy controls intraocular retinoblastoma without requiring radiation.
  • H. Chan, G. Deboer, B. Gallie
  • Medicine
    Clinical cancer research : an official journal of the American Association for Cancer Research
  • 1996
TLDR
It is suggested that cyclosporin improves the long-term response of retinoblastoma to chemotherapy, possibly by more than one mechanism.
Chemotherapy with focal therapy can cure intraocular retinoblastoma without radiotherapy.
TLDR
This pilot study suggests that most retinoblastomas are curable by combining chemotherapy with cyclosporine therapy, laser therapy, and cryotherapy, without requiring external beam radiotherapy.
Chemoreduction and local ophthalmic therapy for intraocular retinoblastoma.
TLDR
In retinoblastoma patients with Reese-Ellsworth eye groups 1, 2, or 3, systemic chemotherapy used with local ophthalmic therapies can eliminate the need for enucleation or EBRT without significant systemic toxicity.
Preliminary results of primary chemotherapy in retinoblastoma.
TLDR
Primary chemotherapy may result in the same eye retention rate as conventional external beam therapy avoiding the unacceptable high rate of secondary non-ocular cancers in the latter.
Results of combined chemotherapy and radiotherapy for advanced intraocular retinoblastoma.
TLDR
Although most of the treated group V eyes could be salvaged with chemotherapy plus radiotherapy, the resultant visual acuity was often poor, and of the 12 surviving children, 5 have aVisual acuity better than l/60 in at least 1 eye.
Treatment of Retinoblastoma Patients With Chemoreduction Plus Local Therapy: Experience of the AC Camargo Hospital, Brazil
TLDR
Chemoreduction combined with local therapy, with or without plaque radiotherapy, is efficacious in avoiding enucleation and the use of external beam radiation therapy for children with intraocular retinoblastoma.
Combined chemotherapy and local treatment in the management of intraocular retinoblastoma.
TLDR
Although 8 out of 21 eyes with group V retinoblastoma may be salvaged after chemoreduction and local therapies, enucleation remained the treatment of choice in those eyes with total retinal detachment and diffuse vitreous seeding.
Chemoreduction in the initial management of intraocular retinoblastoma.
TLDR
Tumor shrinkage with chemoreduction may allow treatment with less invasive measures, such as cryotherapy, laser photocoagulation, thermotherapy, or plaque radiotherapy, thereby avoiding enucleation and external beam radiotherapy.
...
...