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| {{CMG}}; {{AE}} {{Sahar}} {{Simrat}} | | {{CMG}}; {{AE}} {{Sahar}} {{Simrat}} |
| ==Overview== | | ==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]]. | | There are different modalities of treatment available for retinoblastoma. The feasibility of each strategy depends on the [[Cancer staging|stage]] of retinoblastoma at the time of [[diagnosis]]. |
| ==Surgery== | | ==Surgery== |
| [[Enucleation]] is the most commonly applied method for the treatment of [[retinoblastoma]].<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>
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| <br>
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| This method is [[Indication|indicated]] for:
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| *Unilateral or [[bilateral]] group E [[disease]]
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| *Unilateral group D [[disease]]
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| *Maintenance of [[tumor]] activity in a blind eye after treatment for primary [[tumor]]
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| ==Other interventions==
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| Other treatment [[Modality|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>
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| ===[[External beam radiotherapy]]===
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| The feasibility of [[external beam radiotherapy]] depends on the stage of [[retinoblastoma]] at the time of [[diagnosis]].<br>
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| The globe preservation rate with this method varies according to the stage of the [[tumor]] at the time of [[diagnosis]]:
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| Groups I–II eyes:95%
| | * [[Enucleation]] is the most commonly applied method for the treatment of retinoblastoma.<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> |
| | * This method is [[Indication (medicine)|indicated]] for: |
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| Groups IV and V eyes:50%
| | **Unilateral or [[bilateral]] group E [[disease]] |
| | | **Unilateral group D [[disease]] |
| This method is [[Indication (medicine)|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>
| | **Maintenance of [[tumor]] activity in a [[Blindness|blind]] [[eye]] after treatment for [[primary tumor]] |
| 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.<br>
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| [[Contraindications]] of [[External beam radiotherapy|EBRT]]:
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| *Children less than 1 year of age due to the risk secondary [[malignancies]] | |
| *For eyes with dismal visual potential | |
| *In primary therapy of [[retinoblastoma]]
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| ===[[Brachytherapy]]===
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| [[Indication (medicine)|Indications]]: | |
| *Primary treatment | |
| *Residual tumor following [[Laser therapy|photocoagulation]]/[[thermotherapy]]/thermo-chemotherapy/[[cryotherapy]]
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| *[[Tumor]] recurrence | |
| *[[Tumor]] less than 15 mm in diameter | |
| [[Contraindication]]:
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| *Presence of diffuse [[vitreous]] seeding | |
| ===[[Thermotherapy]]===
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| *[[Tumor|Tumors]] not more than 3 mm in diameter, with no and traction, [[retinal]] vascular occlusion evidence of seeding, and located posterior to the equator
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| *Primary treatment
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| *[[Consolidation (medicine)|Consolidation]] treatment
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| *[[Tumor]] recurrence
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| ===Thermochemotherapy===
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| [[Indication (medicine)|Indications]]: | |
| *[[Tumors]] not more than 12 mm in diameter with no evidence of seeding, and located posterior to the equator
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| *[[Consolidation (medicine)|Consolidation]] treatment
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| ===[[Laser photocoagulation]]===
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| This method is [[Indication (medicine)|indicated]] for intraocular [[retinoblastoma]] and one of the following factors:
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| *[[Consolidation (medicine)|Consolidation]] of large [[Tumor|tumors]] after systemic [[chemotherapy]]
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| *For the treatment of small peripheral or posterior tumors as the sole [[modality]]
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| *For the eradication of small [[tumor]] recurrences following [[chemotherapy]] and/or [[radiotherapy]]
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| This method is suitable for treating [[tumors]] with the following characteristics:
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| * 3.0 mm or less in diameter
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| * 2.0 mm or less in thickness
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| *Without seeding into the adjacent [[vitreous]]
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| ===[[Cryotherapy]]===
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| [[Indication (medicine)|Indications]]:
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| *[[Tumors]] not more than 3 mm in diameter with no evidence of seeding, and located anterior to the equator
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| *Primary treatment
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| *[[Consolidation (medicine)|Consolidation]] treatment
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| *[[Tumor]] recurrence
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| ==References== | | ==References== |
| {{reflist|2}} | | {{reflist|2}} |
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| [[Category:Medicine]] | | [[Category:Medicine]] |
| [[Category:Oncology]] | | [[Category:Oncology]] |
| [[Category:Up-To-Date]] | | [[Category:Up-To-Date]] |
| [[Category:Primary care]]
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| [[Category:Surgery]] | | [[Category:Surgery]] |