An external beam treatment technique for retinoblastoma

The main difficulty in the irradiation of retinoblastoma has been to deliver a high uniform dose to the entire retinal surface and spare the lens. Conventional techniques are inadequate to deliver an acceptable dose distribution especially for cases when there are both anterior and posterior lesions. We have developed a procedure to deliver a high dose anteriorly at the ora serrata for a compromise of about 30-35% of the target dose to the lens. The technique consists of 3 pairs of non-coplanar arcs using a 4 MV accelerator. This technique may offer a higher probability of tumor control and cure when gross tumor is present at the ora serrata when compared to the conventional techniques using lateral techniques.