Editorial

Inhibiting Angiogenesis in Retinoblastoma
Rajendra S. Apte, J. William Harbour

Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Mo., USA

Address of Corresponding Author

Ophthalmic Res 2007;39:188-190 (DOI: 10.1159/000103578)

  Abstract

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Retinoblastoma is the most common cancer of the eye in children and is uniformly fatal if left untreated. Over the past century, there have been great strides in treatment that have resulted in survival rates greater than 95% in developed countries [1]. However, currently available treatments have serious drawbacks, and many retinoblastoma-bearing eyes continue to require enucleation. External beam radiotherapy, while highly effective in many cases, markedly increases the risk of second primary cancers in the field of radiation in young children with the heritable form of retinoblastoma, which represents about 40% of all cases [2]. Even in nonheritable cases, radiation can induce disfiguring midfacial hypoplasia. Because of these shortcomings, external beam radiotherapy has been largely replaced by systemic chemotherapy - usually a combination of carboplatin, vincristine and etoposide [3, 4]. When combined with focal laser treatment and cryotherapy, chemotherapy allows many eyes to be salvaged without external radiation. Indeed, the success of combination chemotherapy and focal treatment has spurred the development of a new international classification for intraocular retinoblastoma based on systemic chemotherapy. Nevertheless, chemotherapy has its own drawbacks, including bone marrow suppression, infections and possibly second cancers such as leukemia. In addition, chemotherapy has done little to reduce the need for enucleation in eyes with advanced disease. Sadly, many children with advanced 'group D' disease end up being treated with external beam radiotherapy after a full course of chemotherapy has failed, thereby exposing them to the risks of both therapies. Thus, despite many successes in treating retinoblastoma, there is still a long way to go.

Copyright © 2006 S. Karger AG, Basel

  Author Contacts

J. William Harbour, MD
Department of Ophthalmology and Visual Sciences
Washington University School of Medicine, Campus Box 8096
660 South Euclid Avenue, St. Louis, MO 63124 (USA)
Tel. +1 314 362 3315, Fax +1 314 747 5073, E-Mail harbour@wustl.edu

  Article Information

Received: March 6, 2007
Accepted after revision: April 2, 2007
Published online: June 6, 2007
Number of Print Pages : 3
Number of Figures : 0, Number of Tables : 0, Number of References : 20