Study Shows Some Children with Eye Cancer Can Avoid Chemotherapy

French researchers have found that some children with low-risk retinoblastoma who are treated with surgery can safely skip post-surgery chemotherapy without the disease returning or spreading. And those with intermediate- or high-risk retinoblastoma can undergo a less aggressive chemotherapy treatment.

Avoiding or reducing chemotherapy spares children from possible side effects. Some of the chemotherapy drugs used to treat retinoblastoma can have serious long term side effects including heart or nerve damage, hearing loss, and even a higher risk of developing leukemia later on.

Retinoblastoma is a cancer of the retina, which is part of the eye. About 200 to 300 cases occur each year in the US. Almost all retinoblastoma patients are very young children; the average age at diagnosis is 2. More than 90% of patients are cured.

Retinoblastoma can occur in one or both eyes. The study looked at children who had the cancer in one eye who were treated by having the eye surgically removed. Chemotherapy is sometimes given after surgery in these cases when the tumor extends into other parts of the eye, making it possible the cancer has spread.

The study included 123 children who were classified as low-risk, intermediate-risk, or high-risk, depending on the extent of the tumor within the eye. The 70 children with low-risk retinoblastoma received no chemotherapy after surgery. The 52 children with intermediate-risk retinoblastoma received 4 courses of chemotherapy after surgery, and the only child with high-risk retinoblastoma received 6 courses of chemotherapy after surgery.

Researchers followed the children for an average of almost 6 years. At the end of the follow-up period, none of the children had any worsening, spreading, or return of the cancer.

The study was published early online March 4, 2013 in the Journal of Clinical Oncology.

The study’s authors say their results demonstrate that it’s safe for low-risk retinoblastoma patients to go without post-surgery chemotherapy, and suggest it could be safe for some intermediate-risk retinoblastoma patients to get a lower dose of chemotherapy, or perhaps even go without it.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Results of a Multicenter Prospective Study on the Postoperative Treatment of Unilateral Retinoblastoma Following Primary Enucleation. Published early online March 4, 2013 in the Journal of Clinical Oncology. First author: Isabelle Aerts, MD, Institut Curie, Paris.

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