Eye-preserving therapy for retinoblastoma: new evidence and future perspectives.

Retinoblastoma is the most common ocular tumour in children aged 10 years or younger. In high-income countries, it is highly curable and an increasing number of children preserve vision through conservative therapies—as such, retinoblastoma is considered a success story. However, unlike other paediatric tumours, this success was not achieved through prospective studies by major cooperative groups or randomised trials to systematically test aspects of retinoblastoma management. Historically, new treatments have been implemented on the basis of single-centre experiences in high-income countries. However, in low-income and middle-income countries, retinoblastoma is substantially affected by inequality. 1 Canturk S Qaddoumi I Khetan V et al. Survival of retinoblastoma in less-developed countries impact of socioeconomic and health-related indicators. Br J Ophthalmol. 2010; 94: 1432-1436 Crossref PubMed Scopus (138) Google Scholar Delayed diagnosis, difficulties in accepting eye enucleation by affected families, treatment abandonment, and the toxicity of treatments all substantially contribute to worsening the outcomes of children with retinoblastoma. 2 Chantada GL Qaddoumi I Canturk S et al. Strategies to manage retinoblastoma in developing countries. Pediatr Blood Cancer. 2011; 56: 341-348 Crossref PubMed Scopus (93) Google Scholar Intravenous versus super-selected intra-arterial chemotherapy in children with advanced unilateral retinoblastoma: an open-label, multicentre, randomised trialOur findings show that intra-arterial chemotherapy could significantly improve the globe salvage rate in children with advanced unilateral retinoblastoma compared with intravenous chemotherapy, with mild systemic complications and no difference in overall survival rate. Intra-arterial chemotherapy could be an acceptable first-line treatment in children with advanced unilateral retinoblastoma. Full-Text PDF