Treatments for intraocular retinoblastoma

Intraocular retinoblastoma is retinoblastoma that is contained within the eyes and has not spread to other parts of the body. The treatment for intraocular retinoblastoma depends on:

• whether the cancer is in 1 or both eyes
• the number of tumours in the eye
• the size of the tumour or tumours in the eye
• whether your child’s vision can be saved
• the location of the tumour
• which treatments were used previously

If retinoblastoma is in both eyes, treatment for each eye may be different, depending on the size of the tumour. Doctors will try to save at least 1 eye, if possible, so that your child keeps some vision.

The following are treatment options for intraocular retinoblastoma. The healthcare team will suggest treatments based on your child’s needs and work with you to develop a treatment plan.

The following types of surgery are commonly used to treat intraocular retinoblastoma and recurrent intraocular retinoblastoma.

Cryosurgery uses extreme cold to freeze and destroy cancer cells.

Laser surgery uses a powerful, narrow beam of light (called an infared laser) to deliver heat to destroy cancer cells.

Enucleation is surgery to remove the eye. Enucleation may be used if:

• the tumour is very large
• vision is unlikely to be preserved
• the cancer recurs or doesn’t respond to other treatments

Find out more about surgery for retinoblastoma.

Chemotherapy uses drugs to destroy cancer cells. It may be used with cryosurgery or laser surgery. Chemotherapy may also be used after the eye is removed to reduce the risk of cancer coming back.

Chemotherapy for intraocular retinoblastoma may be systemic or regional. The type of chemotherapy used along with other treatments may depend on the size of the tumour or tumours in the eye. If there are large tumours in both eyes, chemotherapy may be used first to try to shrink the tumours and avoid surgery in both eyes.

The most common combination of systemic chemotherapy drugs used is carboplatin, etoposide and vincristine. This combination is usually given through a needle in a vein (intravenously).

The most common drugs used for regional chemotherapy are melphalan and topotecan used either alone or in combination.

Find out more about chemotherapy for retinoblastoma.

Radiation therapy uses high-energy rays or particles to destroy cancer cells. You may be offered internal or external radiation therapy for intraocular retinoblastoma.

Brachytherapy (plaque therapy) is a type of internal radiation therapy. It uses a radioactive material that is placed directly on the eye. Brachytherapy is most commonly used to treat intraocular retinoblastoma.

External radiation therapy uses a machine to direct radiation through the skin to the tumour and some of the tissue around it. It may be used to treat recurrent intraocular retinoblastoma or intraocular retinoblastoma that is in both eyes and doesnʼt respond to other treatments. External radiation therapy is currently used very rarely as it increases the risk of second cancers.

Find out more about radiation therapy for retinoblastoma.

Children with cancer may be treated in a clinical trial. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.

Follow-up after treatment is an important part of cancer care. Children will need to have regular follow-up visits, especially in the first 5 years after treatment has finished. These visits allow the healthcare team to follow your childʼs progress and recovery from treatment, and to watch for recurrence. Find out more about follow-up care, life after treatment and long-term survivorship.