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05-09-2014 | Ophthalmologic cancers | Article

11. Retinoblastoma: Intravenous Chemotherapy

Authors: MD, MS Rajkumar Venkatramani, MD, MPH Rima Fuad Jubran

Publisher: Springer Berlin Heidelberg


The management of patients with intraocular retinoblastoma has changed dramatically in the past 20 years with the introduction of primary systemic chemotherapy. Before 1990, systemic chemotherapy had been used to treat patients with extraocular disease, with less than optimal results. In the early 1990s, several investigators from North America and the United Kingdom began using chemotherapy agents that were effective against central nervous system tumors, to treat intraocular retinoblastoma. The rationale was to achieve decrease in intraocular tumor volume with systemic chemotherapy (chemoreduction) so as to allow better tumor kill with local treatment using photocoagulation and cryotherapy. Further, it was hoped that the use of chemotherapy would help to eliminate the need for external beam radiation therapy (EBRT) in this patient population susceptible to second malignancy.

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