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Radiation to treat retinoblastoma in a young child

Radiation to treat retinoblastoma in a young child

Question

Dear OncoLink "Ask The Experts,"
My eight-month-old grandson has retinoblastoma. Can you give me some information about the use of radiation in treating a child this young?  

Answer

Hui-Kuo G. Shu, MD, PhD, Assistant Professor Dept. of Radiation Oncology University of Pennsylvania, responds:

The standard for the treatment of retinoblastoma has been evolving and newer approaches have increasingly avoided radiation therapy, when possible. These newer approaches often involve the use of chemotherapy to reduce tumor size followed by local therapies (i.e. laser photocoagulation, cryotherapy). Radiation can effectively treat retinoblastoma and there are still many situations where radiation therapy is an appropriate and viable treatment even in patients as young as eight months. However, this therapy can have late sequelae including but not necessarily limited to temporal bone and orbital hypoplasia, cataracts, secondary cancers and decreased tearing. Treatments are generally tailored for each particular patient based on many factors and may range from chemotherapy/local therapy in less advanced cases to radiation therapy for more advanced cases where vision preservation is still possible to enucleation in advanced cases where visual preservation is no longer achievable. As always, you should consult the child's physician to discuss the various treatment options that are appropriate in the particular case.