Retinoblastoma surgery: Difference between revisions
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*Maintenance of tumor activity in a blind eye after treatment for primary tumor | *Maintenance of tumor activity in a blind eye after treatment for primary tumor | ||
==Other interventions== | ==Other interventions== | ||
Treatment modalities which are currently available for retinoblastoma include: | Treatment modalities which are currently available for retinoblastoma include:<ref name="KimMurphree2015">{{cite journal|last1=Kim|first1=Jonathan W.|last2=Murphree|first2=A. Linn|last3=Singh|first3=Arun D.|title=Retinoblastoma: Treatment Options|year=2015|pages=89–107|doi=10.1007/978-3-662-43451-2_9}}</ref> | ||
===External beam radiotherapy=== | ===External beam radiotherapy=== | ||
The feasibility of external beam radiotherapy depends on the stage of retinoblastoma at the time of diagnosis.<br> | |||
* | The globe preservation rate with this method varies according to the stage of the tumor at the time of diagnosis: | ||
Groups I–II eyes:95% | |||
Groups IV and V eyes:50% | |||
This method is indicated as salvage therapy for seeding following unsuccessful chemotherapy, however, the decision to use this method of treatment must be made on a case by case basis.<br> | |||
The dose to target tumoral cells of retina ranges from 3,600 to 4,500 cGy administered in 180–200 cGy daily fractions 5 times/week.<br> | |||
Contraindications of EBRT: | |||
*Children less than 1 year of age due to the risk secondary malignancies | |||
*For eyes with dismal visual potential | |||
*In primary therapy of retinoblastoma | |||
===Brachytherapy=== | ===Brachytherapy=== | ||
Indications: | |||
*Primary treatment | |||
*Residual tumor following photocoagulation/thermotherapy/thermo-chemotherapy/cryotherapy | |||
*Tumor recurrence | |||
*Tumor less than 15 mm in diameter | |||
Contraindication: | |||
*Presence of diffuse vitreous seeding | |||
===Thermotherapy=== | ===Thermotherapy=== | ||
*Tumors not more than 3 mm in diameter, with no and traction, retinal vascular occlusion evidence of seeding, and located posterior to the equator | |||
*Primary treatment | |||
*Consolidation treatment | |||
*Tumor recurrence | |||
===Thermochemotherapy=== | |||
Indications: | |||
*Tumors not more than 12 mm in diameter with no evidence of seeding, and located posterior to the equator | |||
*Consolidation treatment | |||
===Laser photocoagulation=== | ===Laser photocoagulation=== | ||
Indications: | |||
*Tumors not more than 3 mm in diameter, with no occlusion evidence of seeding, and located posterior to the equator | |||
*Primary treatment | |||
*Consolidation treatment | |||
*Tumor recurrence | |||
===Cryotherapy=== | ===Cryotherapy=== | ||
Indications: | |||
*Tumors not more than 3 mm in diameter with no evidence of seeding, and located anterior to the equator | |||
*Primary treatment | |||
*Consolidation treatment | |||
*Tumor recurrence | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 15:45, 19 May 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sahar Memar Montazerin, M.D.[2] Simrat Sarai, M.D. [3]
Overview
Surgery
Enucleation is the most commonly applied method for the treatment of retinoblastoma.[1]
This method indicated for:
- Unilateral or bilateral group E disease
- Unilateral group D disease
- Maintenance of tumor activity in a blind eye after treatment for primary tumor
Other interventions
Treatment modalities which are currently available for retinoblastoma include:[1]
External beam radiotherapy
The feasibility of external beam radiotherapy depends on the stage of retinoblastoma at the time of diagnosis.
The globe preservation rate with this method varies according to the stage of the tumor at the time of diagnosis:
Groups I–II eyes:95%
Groups IV and V eyes:50%
This method is indicated as salvage therapy for seeding following unsuccessful chemotherapy, however, the decision to use this method of treatment must be made on a case by case basis.
The dose to target tumoral cells of retina ranges from 3,600 to 4,500 cGy administered in 180–200 cGy daily fractions 5 times/week.
Contraindications of EBRT:
- Children less than 1 year of age due to the risk secondary malignancies
- For eyes with dismal visual potential
- In primary therapy of retinoblastoma
Brachytherapy
Indications:
- Primary treatment
- Residual tumor following photocoagulation/thermotherapy/thermo-chemotherapy/cryotherapy
- Tumor recurrence
- Tumor less than 15 mm in diameter
Contraindication:
- Presence of diffuse vitreous seeding
Thermotherapy
- Tumors not more than 3 mm in diameter, with no and traction, retinal vascular occlusion evidence of seeding, and located posterior to the equator
- Primary treatment
- Consolidation treatment
- Tumor recurrence
Thermochemotherapy
Indications:
- Tumors not more than 12 mm in diameter with no evidence of seeding, and located posterior to the equator
- Consolidation treatment
Laser photocoagulation
Indications:
- Tumors not more than 3 mm in diameter, with no occlusion evidence of seeding, and located posterior to the equator
- Primary treatment
- Consolidation treatment
- Tumor recurrence
Cryotherapy
Indications:
- Tumors not more than 3 mm in diameter with no evidence of seeding, and located anterior to the equator
- Primary treatment
- Consolidation treatment
- Tumor recurrence
References
- ↑ 1.0 1.1 Kim, Jonathan W.; Murphree, A. Linn; Singh, Arun D. (2015). "Retinoblastoma: Treatment Options": 89–107. doi:10.1007/978-3-662-43451-2_9.