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Updated: Mar 21, 2026
Reconstruct Human Retinoblastoma In Vitro
Published on: October 11, 2022
Low-Dose Chemoreduction for Infants Diagnosed with Retinoblastoma before 6 Months of Age
Jesse L Berry1, Rima Jubran2, Thomas C Lee1
1The Vision Center, Children's Hospital Los Angeles, USC Eye Institute, Los Angeles, Calif., USA.
Insights
Infants with retinoblastoma diagnosed before six months of age can achieve comparable globe salvage rates using reduced-dose chemoreduction (CRD). Two-thirds of these young patients ultimately required CRD for successful treatment.
Area of Science:
- Pediatric Ophthalmology
- Ophthalmology
- Oncology
Background:
- Retinoblastoma is the most common intraocular malignancy in children.
- Infants diagnosed before six months of age present unique treatment challenges due to potential toxicity of therapies.
- Reduced-dose chemotherapy regimens are often considered for this age group.
Purpose of the Study:
- To evaluate treatment outcomes in infants diagnosed with retinoblastoma before six months of age.
- To assess the necessity and efficacy of chemoreduction (CRD) in this cohort.
- To determine factors influencing the need for CRD and globe salvage.
Main Methods:
- Retrospective review of 126 eyes from 72 infants diagnosed between 2000 and 2009.
- Systemic chemoreduction (CRD) administered when local treatments were insufficient.
- Primary outcome measures included the need for CRD and globe salvage rates.
Main Results:
- 67% of infants required CRD, with 56% receiving it before six months of age.
- Overall globe salvage was 62%, reaching 93% for Group A-C disease.
- No CRD-related hospitalizations occurred; 100% survival was observed.
Conclusions:
- Reduced-dose CRD combined with focal modalities achieves globe salvage rates comparable to older retinoblastoma patients.
- Two-thirds of infants ultimately required CRD for globe salvage.
- Bilateral disease and advanced group classification (D/E) at presentation increased the likelihood of needing CRD.
Aim:
The purpose of this study was to evaluate the outcomes of infants diagnosed with retinoblastoma before 6 months of age, including the need for chemoreduction (CRD). In this age group, dosage of CRD was reduced due to its potential for toxicity.
Methods:
This is a retrospective review from 2000 to 2009 that includes 126 eyes of 72 infants (18 unilateral, 54 bilateral). Systemic CRD was administered when local modalities failed or were considered inadequate. Primary outcome measures were the need for CRD and globe salvage.
Results:
Of the 72 infants diagnosed before 6 months of age, 48 (67%) ultimately required CRD for globe salvage, 40 (56%) patients before 6 months of age. Globe salvage was achieved in 62% (78/126) of eyes overall and in 93% (68/73) of eyes with Group A-C disease. No patient was hospitalized for CRD-related illness; survival was 100%. The mean follow-up was 52.9 months (range 1-148 months).
Conclusion:
Utilizing a combination of focal modalities and reduced-dose CRD, children diagnosed with retinoblastoma before 6 months of age attain globe salvage rates comparable to those of older age groups. Two thirds of the infants ultimately required CRD for globe salvage. Bilateral disease as well as Group D and E classification in at least one eye at presentation increased the chance of requiring CRD (p < 0.0001 and p < 0.016, respectively).
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