Management of Intraocular Retinoblastoma: ICMR Consensus Guidelines.

Suyash Kulkarni, Girish Chinnaswamy, Tanvir Kaur, Rachna Meel, Lata Singh, Sameer Bakhshi, Venkatraman Radhakrishnan, Renu Madan, Archana Sasi, R S Dhaliwal

Journal: Indian journal of pediatrics 2024;91(11):1166-1176

PMID: 38609685

Abstract

Retinoblastoma (RB) is the most common childhood intraocular malignancy. Delayed presentation due to a lack of awareness and advanced intraocular tumors are a common scenario in low-middle income countries (LMICs). Remarkable treatment advances have been made in the past few decades allowing globe salvage in advanced intraocular RB (IORB) including systemic chemotherapy with focal consolidation and targeted treatments like intraarterial chemotherapy and intravitreal chemotherapy. However, a lack of availability and affordability limits the use of such advances in LMICs. External beam radiotherapy, despite risk of second cancers in RB with germline mutations, still remains useful for recalcitrant RB not responding to any other treatment. When choosing conservative treatment for advanced IORB, the cost and long duration of treatment, morbidity from multiple evaluation under anesthesias (EUAs), side effects of treatment and risk of treatment failure need to be taken into account and discussed with the parents. In this article, the authors discuss the ICMR consensus guidelines on the management of IORB.

© 2024. The Author(s), under exclusive licence to Dr. K C Chaudhuri Foundation.

Address: Department of Oculoplasty and Ocular Oncology Services, Dr. Rajendra Prasad Centre of Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, 110 029, India. [email protected].; Department of Interventional Radiology, Tata Memorial Hospital, Parel, Mumbai, India.; Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.; Department of Pediatric Oncology, Tata Memorial Hospital, Parel, Mumbai, India.; Department of Medical Oncology and Pediatric Oncology, Cancer Institute (W.I.A), Adyar, Chennai, India.; Department of Radiotherapy and Oncology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.; Department of Medical Oncology, Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.; Division of Non-communicable Diseases (NCD Division), Indian Council of Medical Research (ICMR), New Delhi, India.

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