Abstract
In reply Dr Hernandez addresses several issues we appreciate the opportunity to clarify. There are several clear reasons for using chemotherapy in addition to local modalities for RE group I and II tumors. 1. In the RE classification, group I tumors are less than 4 disc diameters (6 mm) in greatest diameter and are located posterior to the equator. Cryotherapy is not recommended for tumors posterior to the equator. 1 Traditional photocoagulation is recommended only for tumors no greater than 3 to 4 mm in diameter 2 away from visually important retina. Most group I tumors occur in the posterior pole of young infants with a family history of retinoblastoma. Because of their posterior location, EBR, not cryotherapy or laser photocoagulation, has been the most common treatment. 2 The risk of radiationinduced second malignant neoplasms in children younger than 1 year 3,4 led us to search for an alternative to
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