Conservative treatments of intraocular retinoblastoma

Ophthalmology. 2008 Aug;115(8):1405-10, 1410.e1-2. doi: 10.1016/j.ophtha.2007.11.009. Epub 2008 Jan 25.


Objective: To describe the efficacy of conservative management of retinoblastoma by an association of conservative ocular therapies and chemothermotherapy.

Design: Phase II prospective nonrandomized trial.

Participants: Eighty-three children were included (115 eyes).

Methods: Conservative ocular therapies and chemothermotherapy (intravenous carboplatin followed by transpupillary thermotherapy to the tumor) after chemoreduction by 2 cycles of carboplatin and etoposide.

Main outcome measures: Use of external beam therapy and ocular tumor control.

Results: One hundred fifteen of the 147 affected eyes were eligible for conservative management. Nineteen children had unilateral lesions (22.8%), and 64 (77.1%) had bilateral lesions. Sixty-six children received neoadjuvant chemotherapy before ocular therapy, which consisted of one or a combination of several techniques: chemothermotherapy (65 children [86 eyes]) with a mean of 3 cycles per child, thermotherapy alone (22 children [24 eyes]), cryoapplication (49 children [58 eyes]), and iodine 125 brachytherapy (26 children [29 eyes]). Tumor control was achieved for 97 eyes (84%). At the end of the study, external beam radiotherapy (EBR) was necessary for a total of 9 children (11%) and 13 eyes (12%). Enucleation was necessary for a total of 23 eyes (20%), because of complications in 5 cases.

Conclusions: Neoadjuvant chemotherapy with 2 cycles of carboplatin and etoposide followed by ocular therapy and chemothermotherapy achieves satisfactory tumor control and permits a low need for EBR.

Publication types

  • Clinical Trial, Phase II
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Brachytherapy
  • Carboplatin / administration & dosage
  • Child, Preschool
  • Cryotherapy
  • Etoposide / administration & dosage
  • Eye Enucleation
  • Female
  • Follow-Up Studies
  • Humans
  • Hyperthermia, Induced*
  • Infant
  • Iodine Radioisotopes / therapeutic use
  • Male
  • Neoadjuvant Therapy*
  • Prospective Studies
  • Radiotherapy, High-Energy
  • Retinal Neoplasms / pathology
  • Retinal Neoplasms / therapy*
  • Retinoblastoma / pathology
  • Retinoblastoma / therapy*
  • Treatment Outcome


  • Iodine Radioisotopes
  • Etoposide
  • Carboplatin