Chemotherapy for retinoblastoma: An expanding area of clinical research

RB emerges as a rather chemosensitive but not yet chemocurable disease, since tumor reduction up to CR is frequently reported, but so is regrowth of the tumor. For intra-ocular disease this is circumvented by combining chemotherapy with frequent local treatments like diodelaser-, cryo- or thermocoagulation. The goals are to increase tumor control without the use of EBRT and to decrease local ophthalmic complications, like retinal detachment, vascular changes in the retina and, periretinal fibrosis. Such changes can eventually lead to loss of vision [8]. Ongoing efforts to optimize these types of treatment are thus worthwhile. For extra-ocular disease, the high regrowth potential of RB mainly in the CNS is much more difficult to circumvent. This remains a big problem since most patients are far too young for craniospinal radiotherapy and even then a high chance of recurrent disease remains present. Prevention of RB regrowth remains a major challenge; until now, means of circumventing chemoresistant disease remain to be found.