Update on Retinoblastoma Therapies
Abstract
1. Introduction
1.1. Overview of Retinoblastoma
1.2. RB Staging and Classification
1.3. Purpose of the Review
2. Methods
3. Therapeutic Approaches
3.1. Early Treatments
3.1.1. Enucleation
3.1.2. Radiotherapy
3.2. Shift in Treatment Approaches
3.3. Chemotherapy
3.3.1. Intravenous Chemotherapy
3.3.2. Intra-Arterial Chemotherapy
3.3.3. Intravitreal Chemotherapy
3.3.4. Periocular Chemotherapy
3.3.5. Intracameral Chemotherapy
3.4. Surgical Methods
3.4.1. Tylectomy
3.4.2. Chemoplaque
4. Diagnostic and Prognostic Advancements
4.1. Prenatal Diagnosis
4.2. Prognostic Biomarkers
4.3. Liquid Biopsies
5. Outcomes and Efficacy
Eye Salvage Rates
6. Challenges and Limitations
6.1. Advanced Extraocular or Metastatic Retinoblastoma
6.2. Other Clinical Considerations
7. Future Directions
7.1. Innovations in Treatment
7.2. Management and Surveillance
8. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Groups | Description | Clinical Features |
---|---|---|
A | Very low risk | Small tumors (<3 mm), confined to the retina, ≥3 mm from foveola and ≥1.5 mm from optic disc. No subretinal fluid or seeding. |
B | Low risk | Larger tumors (>3 mm), any location not in Group A. May have subretinal fluid ≤ 5 mm from tumor base. No subretinal or vitreous seeding. |
C | Moderate risk | Localized seeding: minimal vitreous/subretinal seeds close to the tumor. Discrete tumor of any size and location. Subretinal fluid confined to one quadrant may be present. |
D | High risk | Diffuse seeding (massive vitreous or subretinal seeds) and/or massive, non-discrete endophytic or exophytic disease. More widespread seeding than Group C. May present with greasy-appearing vitreous seeding or avascular masses. Subretinal seeding may be plaque-like. |
E | Very high risk | Extensive tumor that has destroyed the eye anatomically or functionally with at least one of the following:
|
Treatment | Procedure | Adverse Effects |
---|---|---|
Enucleation | Surgical removal of the affected eye when other treatments fail. |
|
Radiotherapy | Use of external beam or plaque radiation to destroy tumor cells. |
|
Intravenous Chemotherapy (Chemoreduction) | Systemic chemotherapy (e.g., vincristine, etoposide, carboplatin). |
|
Intra-arterial Chemotherapy | Localized delivery via ophthalmic artery. |
|
Intravitreal Chemotherapy | Direct injection into vitreous for vitreous seeding control. |
|
Periocular Chemotherapy | Injection around the eye to increase local drug levels. |
|
Intracameral Chemotherapy | Injection into the anterior chamber (less common). |
|
Tylectomy | Local resection of the tumor (rare, controversial). |
|
Chemoplaque | Radioactive plaque + chemotherapy placed on sclera for localized effect. |
|
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Martínez Arce, C.A.; Villegas, V.M.; Di Nicola, M.; Williams, B.K., Jr.; Murray, T.G. Update on Retinoblastoma Therapies. Medicina 2025, 61, 1219. https://doi.org/10.3390/medicina61071219
Martínez Arce CA, Villegas VM, Di Nicola M, Williams BK Jr., Murray TG. Update on Retinoblastoma Therapies. Medicina. 2025; 61(7):1219. https://doi.org/10.3390/medicina61071219
Chicago/Turabian StyleMartínez Arce, Cristina A., Victor M. Villegas, Maura Di Nicola, Basil K. Williams, Jr., and Timothy G. Murray. 2025. "Update on Retinoblastoma Therapies" Medicina 61, no. 7: 1219. https://doi.org/10.3390/medicina61071219
APA StyleMartínez Arce, C. A., Villegas, V. M., Di Nicola, M., Williams, B. K., Jr., & Murray, T. G. (2025). Update on Retinoblastoma Therapies. Medicina, 61(7), 1219. https://doi.org/10.3390/medicina61071219