Plaque radiotherapy for retinoblastoma: Long-term tumor control and treatment complications in 208 tumors☆
Section snippets
Materials and methods
The clinical records of all patients with the diagnosis of retinoblastoma managed on the Ocular Oncology Service at Wills Eye Hospital, Philadelphia, Pennsylvania, between July 1976 and June 1999 were reviewed. Clinical data were gathered regarding features of the tumor as well as radiation parameters. These features included age at plaque treatment, type of tumor treated with plaque (retinal tumor, subretinal seeds, vitreous seeds), prior treatment to the tumor of concern (chemoreduction,
Results
Of more than 900 patients with retinoblastoma managed on the Ocular Oncology Service between July 1976 and June 1999, 141 were treated at some time during their course with plaque radiotherapy. The clinical parameters regarding the patients and tumor findings are listed in Table 1. Subretinal fluid was found surrounding 31 tumors (15%). Adjacent active vitreous or subretinal seeds, or both, were found over a mean of 1.3 quadrants (median, 1.0 quadrant) and were included in the radiation
Discussion
Brachytherapy (plaque radiotherapy) is a method of delivering focal irradiation to a tumor in an effort to minimize side effects to the surrounding normal tissue. With regard to the eye, brachytherapy is most often used for intraocular malignancies such as choroidal melanoma and retinoblastoma.11, 20 Brachytherapy for retinoblastoma has been used for many years,7, 8, 12, 13, 21, 22, 23, 24 and, presently, I125 is the most commonly used radioisotope for retinoblastoma. The advantages of
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Supported by the Paul Kayser International Award of Merit in Retina Research, Houston, Texas (JAS); the Macula Foundation, New York, New York (CLS); and the Eye Tumor Research Foundation, Philadelphia, Pennsylvania (CLS).