Subconjunctival Carboplatin in RetinoblastomaImpact of Tumor Burden and Dose Schedule

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Abstract
RETINOBLASTOMA is the most common primary intraocular malignancy of childhood and the third most common pediatric cancer.1,2 In the past century, earlier diagnosis and treatment of retinoblastoma have improved survival rates in developed countries dramatically.3-5 Historically, treatment of retinoblastoma was limited to enucleation.6,7 More recent treatment options in the management of retinoblastoma (including external beam radiotherapy, episcleral plaque radiotherapy, cryotherapy, laser photoablation, and systemic chemotherapy) offer the potential of sight preservation.8-10 External beam radiotherapy has played a prominent role in the treatment of retinoblastoma, especially in children with a germline Rb mutation predisposing them to bilateral eye involvement.11-13 Although the efficacy of ionizing radiation treatment has been demonstrated, this therapeutic modality is associated with such complications as facial deformities, cataract, and radiation retinopathy and an increased incidence of second tumors.14-20 To avoid these radiation-related complications, systemic chemotherapy has become standard in the management of retinoblastoma.8,21-24