Retinoblastoma Treatment

Experts at MD Anderson have partnered with physicians at three other leading institutions to form the Retinoblastoma Center of Houston. This group is one of the world's foremost teams in caring for retinoblastoma. They will work together to develop a customized treatment plan just for your child.

Our retinoblastoma treatments

The team that diagnoses and treats your child for retinoblastoma will include several highly trained doctors, including medical oncologists, surgical oncologists, radiation oncologists, ocular pathologists and geneticists. Together, they offer every possible treatment for retinoblastoma, including:

• Intra-arterial chemotherapy
• Intravitreal chemotherapy
• High-dose chemotherapy with stem cell rescue
• Proton therapy
• Brachytherapy
• Laser therapy
• Surgery
• Specialized ocular pathology and tissue harvesting

Doctors who treat retinoblastoma will tell you they have three goals, in order: Save the life. Save the eye. Save the vision. To achieve these goals, they may use the following treatments.

Chemotherapy

Chemotherapy drugs kill cancer cells, control their growth or relieve disease-related symptoms. Chemotherapy may involve a single drug or a combination of two or more drugs, depending on the type of cancer and how fast it is growing. 

Learn more about chemotherapy.

Retinoblastoma chemotherapy is delivered in one of the following ways:

Intra-arterial: A catheter is inserted into a blood vessel near the groin and then steered through the body up to the eye, where chemo is directly delivered. This avoids exposing the patient to systemic chemotherapy. Under certain circumstances, this is the preferred technique for delivering chemotherapy medications.

Intravenous: The drug is injected into a blood vessel and is pumped throughout the body.

Intravitreal: Chemotherapy is injected directly into the eye.

Periocular: The drug is placed around the eye.

High dose chemotherapy with stem cell rescue: This is a form of intravenous chemotherapy. It is an option for patients whose cancer has spread beyond the eye into areas like the liver or central nervous system. These patients are given a very powerful dose of chemotherapy to kill cancer cells.

As a side effect, the medicine also kills the patient’s bone marrow, which makes new blood cells.

The patient then undergoes a stem cell transplant. This procedure is not designed to kill the cancer, but to restart the body’s ability to create blood cells.

A stem cell transplant (also known as a bone marrow transplant) replaces bone marrow with new, healthy bone marrow stem cells. For retinoblastoma, the stem cells are usually taken from the patient before chemotherapy. Patients usually stay in the hospital for three to four weeks after the transplant. Learn more about stem cell transplants.

Laser treatment 

Doctors can use lasers to destroy a retinoblastoma tumor. Laser treatment is often used after chemotherapy to help kill any remaining cancer cells. This is effective for small tumors that are confined to the retina and do not involve the optic disc or the area near it, called the macula, which is the most important part of the retina for vision.

Surgery

Enucleation surgery, or removal of the eye, may be performed when the tumor fills more than half the eyeball, when other structures in the eye are involved or when the retina is detached. Children who undergo this procedure are fitted with an ocular implant and later an artificial eye. Thanks to advances in detection and treatment, enucleation is not used as often as it once was.

Cryoablation

Cryoablation, also known as cryotherapy or cryosurgery, uses cold to kill tumor cells. During the procedure, a special probe is inserted into the tumor and then cooled to temperatures well below freezing. A ball of ice forms at the tip of the probe, freezing and destroying cancerous tissue. Cryotherapy is not as invasive as surgery. It is generally performed as an outpatient procedure. 

Learn more about cryoablation.

Radiation therapy

Radiation therapy uses powerful, focused beams of energy to kill cancer cells. There are several different radiation therapy techniques. Doctors can use these to accurately target a tumor while minimizing damage to healthy tissue.

Learn more about radiation therapy.

Radiation treatments for retinoblastoma may include the following:

Brachytherapy: Brachytherapy delivers radiation therapy with small pieces of radioactive material that are placed on or inside the patient’s body as close to the tumor as possible. This allows doctors to deliver very high doses of radiation directly to the patient’s tumor while limiting radiation exposure to healthy tissue. Also called plaque therapy, this treatment is used for patients with very small tumors. Learn more about brachytherapy.

Proton therapy: Proton therapy is a sophisticated way of delivering radiation therapy. It uses a different type of energy that may allow doctors to target tumors with much more accuracy. This limits damage to nearby healthy tissue and allows for the delivery of a more powerful dose of radiation. 

Proton therapy may be used to treat retinoblastoma that has spread outside the eyeball into nearby structures. Learn more about proton therapy.

Life after cancer

After treatment, retinoblastoma patients should undergo regular cancer screenings and follow-up care to look for cancer recurrence. This is especially important for patients with hereditary disease. These patients are at an increased risk of developing a second cancer over the course of their life.

MD Anderson’s Children’s Cancer Hospital offers expert survivorship care to retinoblastoma patients, including regular screening exams, genetic counseling and testing, and ongoing monitoring for long-term side effects.