Retinoblastoma surgery

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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:

External beam radiotherapy

  • This type of therapy is not recommended as first-line treatment of primary intra-ocular retinoblastoma due to the high risk of secondary malignancies following radiation in patients carrying RB1 gene mutation.[2]
  • This therapy may be helpful in the salvage of the remaining eye which is resistant to another kind of therapies.

Brachytherapy

Brachytherapy involves the placement of a radioactive implant (plaque), usually on the sclera adjacent to the base of a tumor. It is used as the primary treatment or, more frequently, in patients with small tumors or in those who had failed initial therapy including previous EBR therapy.

Thermotherapy

Thermotherapy involves the application of heat directly to the tumor, usually in the form of infrared radiation. It is also used for small tumors.

Laser photocoagulation

Laser photocoagulation is recommended only for small posterior tumors. An argon or diode laser or a xenon arc is used to coagulate all the blood supply to the tumor.

Cryotherapy

Cryotherapy induces damage to the vascular endothelium with secondary thrombosis and infarction of the tumor tissue by rapidly freezing it. Cryotherapy may be used as primary therapy for small peripheral tumors or small recurrent tumors previously treated with other methods.

References

  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.
  2. MacCarthy A, Bayne AM, Brownbill PA, Bunch KJ, Diggens NL, Draper GJ, Hawkins MM, Jenkinson HC, Kingston JE, Stiller CA, Vincent TJ, Murphy MF (June 2013). "Second and subsequent tumors among 1927 retinoblastoma patients diagnosed in Britain 1951-2004". Br. J. Cancer. 108 (12): 2455–63. doi:10.1038/bjc.2013.228. PMC 3694232. PMID 23674091.