The main points in the treatment for retinoblastoma
Department of Ophthalmology, Peking University People's Hospital; Key Laboratory of Vision Loss and Restoration, Ministry of Education; Beijing Key Laboratory for the Diagnosis and Treatment of Retinal and Choroid Diseases, Beijing 100044, China
Thanks to the treatment of retinoblastoma (RB) having improved significantly in recent years, there is an increasing trend to use conservative treatment modalities that aim to preserve the globe as well as vision with minimum mortality. RB therapy is a long-term systemic treatment in clinical practice. Although there are many treatment options for RB therapy, such as cryotherapy, photocoagulation, systemic chemotherapy, enucleation and ophthalmic chemotherapy, it is recommended to consider in accordance with the following key points in gaining a reasonable treatment strategies: to make sure that RB is an intraocular period; to determine whether the intraocular RB to be treated with eye preservation or enucleation; what is the case of eye preservation therapy combined with chemotherapy and how to arrange the follow-up of RB patients. It's more complicated to choice the therapeutic measures for RB in clinical practice. So, the patient's condition, economic capability and medical condition should be evaluated comprehensively. The principle of RB treatment should be followed, which is protecting eyeball and visual function without life damage.
Antoneli CB, Steinhorst F, de Cássia Braga Ribeiro K, et al. Extraocular retinoblastoma: a 13-year experience[J]. Cancer, 2003, 98(6):1292-1298. DOI: 10.1002/cncr.11647.
Shah PK, Narendran V, Kalpana N. Outcomes of intra- and extraocular retinoblastomas from a single institute in South India[J]. Ophthalmic Genet, 2015, 36(3):248-250. DOI: 10.3109/13816810.2013.867450.
Rodriguez-Galindo C, Wilson MW, Haik BG, et al. Treatment of metastatic retinoblastoma[J]. Ophthalmology, 2003, 110(6):1237-1240. DOI: 10.1016/S0161-6420(03)00258-6.
Kaliki S, Shields CL, Rojanaporn D, et al. High-risk retinoblastoma based on international classification of retinoblastoma: analysis of 519 enucleated eyes[J]. Ophthalmology, 2013, 120(5):997-1003. DOI: 10.1016/j.ophtha.2012.10.044.
Shields CL, Shields JA. Basic understanding of current classification and management of retinoblastoma[J]. Curr Opin Ophthalmol, 2006, 17(3):228-234. DOI: 10.1097/01.icu.0000193079.55240.18.
Lee JH, Han JW, Hahn SM, et al. Combined intravitreal melphalan and intravenous/intra-arterial chemotherapy for retinoblastoma with vitreous seeds[J]. Graefe's Arch Clin Exp Ophthalmol, 2016, 254(2):391-394. DOI: 10.1007/s00417-015-3202-0.
Fabian ID, Stacey AW, Johnson KP, et al. Primary intravenous chemotherapy for group D retinoblastoma: a 13-year retrospective analysis[J]. Br J Ophthalmol, 2017, 101(1):82-88.DOI: 10.1136/bjophthalmol-2016-309710.
Kunkele A, Jurklies C, Wieland R, et al. Chemoreduction improves eye retention in patients with retinoblastoma: a report from the German Retinoblastoma Reference Centre[J].Br J Ophthalmol, 2013, 97(10):1277-1283. DOI: 10.1136/bjophthalmol-2013-303452.
Shields CL, Alset AE, Say EA, et al. Retinoblastoma control with primary intra-arterial chemotherapy: outcomes before and during the intravitreal chemotherapy era[J]. J Pediatr Ophthalmol Strabismus, 2016, 53(5):275-284.DOI: 10.3928/01913913-20160719-04.
Munier FL, Mosimann P, Puccinelli F, et al. First-line intra-arterial versus intravenous chemotherapy in unilateral sporadic group D retinoblastoma: evidence of better visual outcomes, ocular survival and shorter time to success with intra-arterial delivery from retrospective review of 20 years of treatment[J]. Br J Ophthalmol, 2017, 101(8):1086-1093. DOI: 10.1136/bjophthalmol-2016-309298.
Abramson DH, Shields CL, Jabbour P, et al. Metastatic deaths in retinoblastoma patients treated with intraarterial chemotherapy (ophthalmic artery chemosurgery) worldwide[J]. Int J Retina Vitreous, 2017, 3:40. DOI: 10.1186/s40942-017-0093-8.
Francis JH, Abramson DH, Ji X, et al. Risk of extraocular extension in eyes with retinoblastoma receiving intravitreous chemotherapy[J]. JAMA Ophthalmol, 2017, 135(12):1426-1429. DOI: 10.1186/s40942-017-0093-8.
Francis JH, Brodie SE, Marr B, et al. Efficacy and toxicity of intravitreous chemotherapy for retinoblastoma: four-year experience[J]. Ophthalmology, 2017, 124(4):488-495.DOI: 10.1001/jamaophthalmol.2017.4600.
Canadian Retinoblastoma Society. National Retinoblastoma Strategy Canadian Guidelines for Care: stratégie thérapeutique du rétinoblastome guide clinique canadien[J]. Can J Ophthalmol, 2009, 44 Suppl 2:S1-88. DOI: 10.3129/i09-194.