Simultaneous bilateral radiation for advanced bilateral retinoblastoma

Area of Science:

• Ophthalmology
• Pediatric Oncology
• Radiation Oncology

Background:

• Retinoblastoma is the most common primary intraocular malignancy in children.
• Advanced bilateral retinoblastoma presents significant treatment challenges.
• Simultaneous bilateral radiation therapy is a less common approach for bilateral cases.

Observation:

• A retrospective review analyzed 34 patients with advanced bilateral retinoblastoma treated initially with simultaneous bilateral radiation.
• Patients presented with bilateral group IV or V retinoblastoma, with a mean age at diagnosis of 13.1 months.
• The study examined treatment outcomes, including survival, secondary tumors, and ocular salvage rates.

Findings:

• The five-year survival rate for these patients was 88% (28/32).
• Two surviving patients (7%) developed secondary nonocular tumors, one within and one outside the radiation field.
• Ocular salvage was challenging, with 44 of 64 treated eyes ultimately enucleated, and 9 of 10 eyes requiring re-irradiation also being enucleated.

Implications:

• Simultaneous bilateral radiation offers a survival benefit for advanced bilateral retinoblastoma.
• The risk of secondary tumors and the need for enucleation warrant careful consideration and long-term follow-up.
• Further research may explore optimizing radiation techniques and adjunct therapies to improve ocular salvage and reduce long-term risks.