Discussion

Abstract

The use of chemotherapy for retinoblastoma is currently a topic of great interest for both ocular oncologists and pediatric oncologists. 1 Shields C.L. Shields J.A. Chemotherapy for retinoblastoma. Med Pediatr Oncol. 2001; 37 ([editorial]): 1-2 Crossref PubMed Scopus (166) Google Scholar Several years ago, chemotherapy was used predominantly for patients with metastatic retinoblastoma. In 1996, success was reported for intravenous chemotherapy, termed chemoreduction, in the management of intraocular retinoblastoma with the goal of decreasing tumor size to allow for conservative treatment and to avoid external beam radiotherapy and enucleation. 2 Shields C.L. DePotter P. Himmelstein B. et al. Chemoreduction in the initial management of intraocular retinoblastoma. Arch Ophthalmol. 1996; 114: 1330-1338 Crossref PubMed Scopus (309) Google Scholar , 3 Murphree A.L. Villablanca J.G. Deegan III, W.F. et al. Chemotherapy plus local treatment in the management of intraocular retinoblastoma. Arch Ophthalmol. 1996; 114: 1348-1356 Crossref PubMed Scopus (385) Google Scholar , 4 Gallie B.L. Budning A. DeBoer G. et al. Chemotherapy with focal therapy can cure intraocular retinoblastoma without radiation. Arch Ophthalmol. 1996; 114: 1321-1328 Crossref PubMed Scopus (340) Google Scholar , 5 Kingston J.E. Hungerford J.L. Madreperla S.A. Plowman P.N. Results of combined chemotherapy and radiotherapy for advanced intraocular retinoblastoma. Arch Ophthalmol. 1996; 114: 1139-1143 Crossref PubMed Scopus (238) Google Scholar In these initial reports, the use of three chemotherapy agents in combination was used to avoid chemoresistance, a problem more likely found after use of only one agent. 6 Shields C.L. Meadows A.T. Shields J.A. In reply Greewald MJ, Goldman S, Strauss L. Combined chemoreduction and adjuvant treatment for intraocular retinoblastoma. Ophthalmology. 1998; 105 ([letter]): 1579-1581 Google Scholar Currently, most oncology centers continue to use multiagent chemotherapy for retinoblastoma.