Retinoblastoma surgery
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Retinoblastoma Microchapters |
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Diagnosis |
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Treatment |
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Retinoblastoma surgery On the Web |
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American Roentgen Ray Society Images of Retinoblastoma surgery |
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Risk calculators and risk factors for Retinoblastoma surgery |
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
There are different modalities of treatment available for the treatment of retinoblastoma. The feasibility of each strategy depends on the stage of retinoblastoma at the time of diagnosis.
Surgery
Enucleation is the most commonly applied method for the treatment of retinoblastoma.[1]
This method is 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
Other 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 tumor 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
- Primary treatment
- Residual tumor following photocoagulation/thermotherapy/thermo-chemotherapy/cryotherapy
- Tumor recurrence
- Tumor less than 15 mm in diameter
- 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
- Tumors not more than 12 mm in diameter with no evidence of seeding, and located posterior to the equator
- Consolidation treatment
Laser photocoagulation
This method is indicated for intraocular retinoblastoma and one of the following factors:
- Consolidation of large tumors after systemic chemotherapy
- For the treatment of small peripheral or posterior tumors as the sole modality
- For the eradication of small tumor recurrences following chemotherapy and/or radiotherapy
This method is suitable for treating tumors with the following characteristics:
- 3.0 mm or less in diameter
- 2.0 mm or less in thickness
- Without seeding into the adjacent vitreous
Cryotherapy
- 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.