Tuesday, January 15, 2008

How to Treat Retinoblastoma


Retinoblastoma is a malignant tumor that arises from the retinal round cells in the eye. It is the most common eye cancer in children and exhibits three types of growth: endophytic growth when the tumor penetrates the internal membrane, exophytic growth is in the subretinal space and diffuse infiltrating growth is a flat infiltration of the retina. The following steps will show how to treat retinoblastoma.


Difficulty: Challenging



Step One

Tailor treatment to the specific patient. Retinoblastomas usually require individualized treatment that should be directed toward controlling the tumor completely and saving as much useful vision as possible.

Step Two

Provide chemotherapy in most cases to reduce the size of the tumor before surgery. Chemotherapy is also the primary treatment mode in some cases and also may be used as prophylactic therapy against a tumor in the optic nerve that has grown past the lamina cribrosa. A combination of carboplatin, etoposide and vincristine is the most common regimen and cyclosporine also may be added to dispense with radiation.

Step Three

Administer radiation therapy only in patients with significant vitreous seeding or progression of the retinoblastoma during chemotherapy. The typical dose is 40 to 45 Gy in two Gy fractions. However, this treatment stops bone growth in the middle of the face and has a high mortality rate.

Step Four

Perform surgery to remove the retinoblastoma in unfavorable cases. The entire eye is removed if useful vision cannot be preserved. These patients usually have total retinal detachments or the posterior segment of the eye has a full tumor.

Step Five

Use cryotherapy or photocoagulation to treat the tumor while retaining some useful vision.

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