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.
Department of Interventional Radiology, Tata Memorial Hospital, Parel, Mumbai, India.
Indian J Pediatr. 2024 Nov;91(11):1166-1176. doi: 10.1007/s12098-024-05095-0. Epub 2024 Apr 13.
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.
视网膜母细胞瘤（RB）是最常见的儿童眼内恶性肿瘤。由于缺乏意识和眼内肿瘤进展，在中低收入国家（LMICs）中，常会出现延迟就诊的情况。在过去几十年中，RB 的治疗取得了显著进展，使得晚期眼内 RB（IORB）能够保留眼球，包括全身化疗联合局部巩固治疗以及动脉内化疗和眼内化疗等靶向治疗。然而，这些进展在 LMICs 中由于可及性和可负担性的限制而无法广泛应用。尽管存在种系突变的 RB 发生二次癌症的风险，外照射放疗对于任何其他治疗方法均无效的难治性 RB 仍然有用。在选择晚期 IORB 的保守治疗时，需要考虑治疗的成本和持续时间、多次全身麻醉下评估（EUAs）的发病率、治疗的副作用以及治疗失败的风险，并与家长进行讨论。本文作者讨论了 ICMR 关于 IORB 管理的共识指南。
