Preliminary experience in treatment of papillary and macular retinoblastoma: evaluation of local control and local complications after treatment with linear accelerator-based stereotactic radiotherapy with micromultileaf collimator as second-line or salvage treatment after chemotherapy

Int J Radiat Oncol Biol Phys. 2011 Dec 1;81(5):1380-6. doi: 10.1016/j.ijrobp.2010.07.033. Epub 2010 Oct 6.


Purpose: To determine the local control and complication rates for children with papillary and/or macular retinoblastoma progressing after chemotherapy and undergoing stereotactic radiotherapy (SRT) with a micromultileaf collimator.

Methods and materials: Between 2004 and 2008, 11 children (15 eyes) with macular and/or papillary retinoblastoma were treated with SRT. The mean age was 19 months (range, 2-111). Of the 15 eyes, 7, 6, and 2 were classified as International Classification of Intraocular Retinoblastoma Group B, C, and E, respectively. The delivered dose of SRT was 50.4 Gy in 28 fractions using a dedicated micromultileaf collimator linear accelerator.

Results: The median follow-up was 20 months (range, 13-39). Local control was achieved in 13 eyes (87%). The actuarial 1- and 2-year local control rates were both 82%. SRT was well tolerated. Late adverse events were reported in 4 patients. Of the 4 patients, 2 had developed focal microangiopathy 20 months after SRT; 1 had developed a transient recurrence of retinal detachment; and 1 had developed bilateral cataracts. No optic neuropathy was observed.

Conclusions: Linear accelerator-based SRT for papillary and/or macular retinoblastoma in children resulted in excellent tumor control rates with acceptable toxicity. Additional research regarding SRT and its intrinsic organ-at-risk sparing capability is justified in the framework of prospective trials.

MeSH terms

  • Antineoplastic Agents / therapeutic use
  • Carboplatin / therapeutic use
  • Cataract / etiology
  • Cataract / pathology
  • Child
  • Child, Preschool
  • Follow-Up Studies
  • Humans
  • Infant
  • Macula Lutea / surgery*
  • Optic Disk / surgery*
  • Optic Nerve Neoplasms / surgery*
  • Organs at Risk
  • Particle Accelerators
  • Radiosurgery / adverse effects*
  • Radiosurgery / instrumentation
  • Radiosurgery / methods
  • Radiotherapy Dosage
  • Retinal Detachment / etiology
  • Retinal Neoplasms / drug therapy
  • Retinal Neoplasms / surgery*
  • Retinoblastoma / drug therapy
  • Retinoblastoma / surgery*
  • Retreatment / methods
  • Salvage Therapy / adverse effects*
  • Salvage Therapy / methods
  • Treatment Outcome


  • Antineoplastic Agents
  • Carboplatin