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Episcleral brachytherapy for retinoblastoma
  1. Jose J Echegaray1,
  2. Yahya A Al-Zahrani2,
  3. Arun Singh1
  1. 1 Department of Ophthalmic Oncology, Cleveland Clinic Foundation, Cole Eye Institute, Cleveland, Ohio, USA
  2. 2 Retina and Vitreous Service, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
  1. Correspondence to Dr Arun Singh, Department of Ophthalmic Oncology, Cleveland Clinic Foundation, Cole Eye Institute, Cleveland, OH 44195, USA; singha{at}


Background/Aims To report visual outcomes, survival outcomes and complications following episcleral brachytherapy (EB) for retinoblastoma.

Methods Retrospective review of retinoblastoma cases treated with EB in a single institution. Survival outcomes were analysed using the Kaplan-Meier method.

Results Eleven tumours of 11 eyes were treated with either iodine-125 or ruthenium-106 EB with a mean apical dose of 44 Gy. The tumours were classified as group B in 5 (46%), C in 3 (27%) or D in 3 (27%) eyes, respectively. Mean follow-up time was 75.4 months. EB served as primary treatment in 3 eyes (27%) and secondary treatment in 8 eyes (73%). Final visual acuity was better than 20/200 in 70% of cases. Globe preservation was achieved in 9 (82%) eyes. Local recurrence occurred in 18% of cases at a mean onset of 17.4 months after EB. Two group D tumours that recurred after secondary EB underwent enucleation. Mean onset of radiation retinopathy was 17.4 months following EB. No metastatic or fatal events were recorded. Kaplan-Meier analysis showed recurrence-free survival and ocular survival of 80% and overall survival of 100% at 5 years after EB.

Conclusion EB is an effective primary or secondary treatment modality for selected retinoblastoma eyes (groups B and C). Advanced group D tumours may represent a risk factor for local recurrence. Visually significant complications such as radiation retinopathy should be anticipated.

  • retinoblastoma
  • episcleral brachytherapy
  • focal consolidation therapy
  • recurrence-free survival
  • ocular survival

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  • Contributors JJE, YAAZ and AS collected and analysed the data. JJE and AS wrote and revised the manuscript, constructed tables and figures, and critically revised the work and references. All authors take responsibility for this study.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article.

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