视网膜母细胞瘤经眼动脉灌注化学药物治疗与经静脉全身化学药物治疗后摘除眼球的组织病理学特征研究

目的探讨视网膜母细胞瘤(RB)经眼动脉灌注化学药物治疗(IAC)或经静脉全身化学药物治疗(IVC)后摘除眼球的临床组织病理学特征。 方法收集首都医科大学附属北京儿童医院眼科2020年1月至2022年3月期间经IAC或IVC治疗后行眼球摘除术的19例(19只眼)RB病例。其中,男性10例(10只眼),女性9例(9只眼);年龄4~45个月,平均年龄(24.7±11.9)个月。根据治疗手段不同分为IAC治疗组和IVC治疗组。记录患者的治疗方法、临床分期(cTNM)、组织病理学分期(pTNM)、组织病理学特征及组织病理学高危因素(HRF),以例数(眼数)和百分比进行描述。 结果采用IAC疗法治疗者8例(8只眼),占42.11 %(8/19),采用IVC疗法治疗者11例(11只眼),占57.89%(11/19)。采用AJCC第8版TNM分期法进行分期,其中IAC治疗组cT2期、cT3期及cT4期分别有4例(4只眼)、3例(3只眼)及1例(1只眼),分别占50.00%(4/8)、37.50%(3/8)及12.50%(1/8),pT1期、pT2期及pT3期分别有5例(5只眼)、1例(1只眼)及2例(2只眼),分别占62.50%(5/8)、12.50%(1/8)和25.00%(2/8);IVC治疗组cT2期、cT3期及cT4期分别有1例(1只眼)、9例(9只眼)及1例(1只眼),分别占9.09%(1/11)、81.82%(9/11)和9.09%(1/11),pT1期、pT2期及pT3期及pT4期分别有1例(1只眼)、6例(6只眼)、3例(3只眼)和1例(1只眼),分别占9.09%(1/11)、54.55%(6/11)、27.27%(3/11)、9.09%(1/11)。全部19例(19只眼)经IAC与IVC治疗的RB组织病理学检查显示肿瘤有不同程度的钙化、出血及坏死,IAC治疗组和IVC治疗组发生脉络膜广泛性萎缩患者分别有8例(8只眼)和2例(2只眼),分别占100%(8/8)和18.18%(2/11),IAC治疗组和IVC治疗组发生血管壁均质性增厚改变者分别有8例(8只眼)和1例(1只眼),分别占100%(8/8)和9.09%(1/11)。全部19例(19只眼)中肿瘤存在HRF者7例(7只眼),占36.84%(7/19)。其中,HRF在cT2期、cT3期及cT4期者分别有1例(1只眼)、4例(4只眼)及2例(2只眼),分别占14.29%(1/7)、57.14%(4/7)及100.00%(2/2)。IAC治疗组和IVC治疗组存在HRF者分别为2例(2只眼)和5例(5只眼),分别占25.00%(2/8)和45.45%(5/11)。 结论IAC治疗后特征性组织病理学改变为脉络膜广泛性萎缩、血管壁呈均质性增厚改变。cTNM分期较高的患者存在组织病理学高危因素风险可能增加。     

视网膜母细胞瘤化学减容加局部治疗的临床疗效分析

目的 总结、探讨视网膜母细胞瘤化学减容加局部治疗的初步疗效.方法 回顾性系列病例研究.分析2005年1月至2007年12月间29例(40只眼)视网膜母细胞瘤(RB)接受化学减容加局部治疗患者的临床资料,化学减容加局部治疗以VEC方案化学缩瘤,辅以冷冻、TTT等局部巩固治疗.随访时间为12～50个月,平均38个月.结果 其中4例单眼发病,25例双眼发病.40只眼参照眼内型RB国际分期,A期14只眼(35%)、B期9只眼(22.5%)、c期4只眼(10%)、D期10只眼(25%)、E期3只眼(7.5%).17只眼存在玻璃体、视网膜下种植.总体眼球保存率为75%(30/40).瘤体呈现退缩模式并稳定的治愈率依分期不同呈现递减趋势,A期100%(14/14)、B期100%(9/9)、C期75%(3/4)、D期40%(4/10)、E期0%(0/3).4只眼肿瘤复发,从化疗结束至复发眼球摘除的平均时间为5.7个月.10只眼最终行眼球摘除,其中C期1只眼、D期6只眼、E期3只眼.随访中无1例死亡或产生白血病等严重并发症.结论 化学减容加局部治疗可以有效保存部分RB患儿的眼球,乃至有用视功能.眼内型RB的国际分期对临床工作具有指导意义.     

视网膜母细胞瘤患者全身化学药物治疗联合眼部治疗的临床疗效观察

目的：观察视网膜母细胞瘤（RB）患者全身化学药物治疗（化疗） 联合眼部治疗的 临床效果。 方法：回顾分析37例56只眼行全身化疗联合眼部治疗的RB患 者的生存率、眼球保留 率以及病情得到良好控制的情况。病情得到良好控制的标准为：（1）眼部肿瘤缩小乃至消 失，肿瘤病灶呈软乳酪样改变或出现钙化和瘢痕化；（2）眼球摘除者未出现眼眶肿瘤复发 ；（3）临床检查未见肿瘤转移。所有患者均至少有一只肿瘤眼分期为Ⅲb期或以上并接受化 疗。根据肿瘤对化疗的反应情况，一般接受6轮全身化疗，每轮化疗间隔3~4周。化疗药物组 成为：长春新碱、环磷酰胺、依托泊甙(VP16)、卡铂。另外,根据情况分别联合激光光凝、 冷冻、经瞳孔温热疗法（TTT）、钌¹⁰⁶放射敷贴器局部放射治疗以及眼球摘除等眼部 治疗。 治疗和观察时间2~59个月，平均观察时间为35个月。 结果：除1例双眼发 病患者眼球摘除手术 后失访外，观察期内30例患者存活，占83.3%；6例患者死亡，占16.6%。30例存活患者的45 只肿瘤眼中，肿瘤分期为I-Ⅱ期(早期)、Ⅲ-Ⅳ期(中期)和Ⅴ期(晚期)者眼球保存率分 别为100%（10只眼）、7 0.0%（10只眼）和14.3%（21只眼），随访期内病情均得到良好控制。6例死亡患者均为肿瘤 分期Ⅳ期 以上，最终死于肿瘤脑转移。 结论：全身化疗联合多种眼部治疗可以有效地治疗RB。     

经眼动脉灌注化学药物治疗与经静脉全身化学药物治疗对单眼晚期视网膜母细胞瘤的临床疗效初探

目的:对比观察经眼动脉灌注化学药物治疗（IAC）和经静脉全身化学药物治疗（IVC）单眼晚期视网膜母细胞瘤（RB）的疗效及并发症。方法:回顾性临床研究。2020年1月至2021年1月分别于保定市儿童医院眼科和北京儿童医院眼科检查确诊的单眼cT2期RB患儿40例（40只眼）纳入研究。其中,男性22例（22只眼）,女性18例...     

脉络膜转移癌的临床特点分析

目的 分析脉络膜转移癌的临床特点以指导治疗.方法 回顾性系列病例研究.收集脉络膜转移癌患者49例(66只眼),均行眼底检查,其中44例行荧光素眼底血管造影检查,12例合并吲哚氰绿造影检查,8例行B超检查.采用经瞳孔温热疗法(TTT)24只眼,联合光敏治疗1只眼.眼敷贴放疗1只眼.,TTT采用的治疗参数为光斑1.2～3.0mm,能量450～1000 mV,时间60 s.做2次TTT者2例,做3次TTT者1例.结果患者中男性14例,女性35例.双眼17例(34.7%).年龄23～74岁,平均47岁.视力小于或等于0.05者13只眼,0.06～0.2者22只眼,大于等于0.3者31只眼.已发现原发肿物40例(81.6%)(行手术切除术25例).其中患乳腺癌16例(32.7%),肺癌(包括支气管1例)14例(28.6%),肝胆肿物3例,结肠癌及胃癌3例,妇科附件肿物2例,鼻咽癌l例(含卵巢黏液囊性腺癌1例),脊柱骨肿物1例,尚未查明原发肿物5例(10.2%),4例尚在检查中.眼底有1个转移灶者58只眼(87.8%).2个转移灶者4只眼(6%).3个及以上转移灶2只眼(包括7个灶1例).根据眼底转移灶所在部位及发展情况,将转移灶分为孤立型,39只眼,占59%(39/66);弥漫型,19只眼,占28.8%(19/66);早期型,8只眼,占12.1%(8/66).荧光素眼底血管造影检查可见早期转移灶处呈低荧光,晚期灶处荧光融合呈中等或强荧光.对8例孤立型转移灶行B超测量,其平均值约为11.5 mm×10.5 mm×3.6 mm,瘤体最高可达4.9 mm.作敷贴放疗的患者1例,观察3个月,瘤体变扁平,维持原视力.作TTT治疗后3例随访各为4、3、2个月.病变稳定,视力不变或轻度下降.结论脉络膜转移癌有其临床特点.眼底病变分型有助于对病情的了解.在全身治疗情况下,埘眼部孤立型及早期型转移灶采用TTT治疗,可使病灶消退,保护视力,对提高患者生活质量有较大帮助.(中华眼科杂志,2009,45:229-233)     

66例视网膜母细胞瘤患儿临床资料分析

目的观察西南地区视网膜母细胞瘤(RB)患眼的临床特点。方法回顾性临床研究。2010年1月至2017年12月在四川大学华西医院眼科检查确诊的RB患儿66例82只眼纳入研究。患儿均行眼部B型超声、眼眶CT或MRI检查,行广角数码视网膜成像系统检查10例。组织病理学检查确诊29例,临床症状结合影像学检查确诊37例。根据肿瘤是否侵及眼眶和视神经分为眼外期和眼内期;后者根据国际眼内期RB分期标准分为A^E期。根据不同分期行相应治疗。回顾分析患儿基本情况、就诊年龄、病程、就诊原因、分期、治疗方案和保眼率。结果66例患儿来自四川、云南、贵州省分别为56、2、2例,西藏自治区6例。可明确常住地43例,其中来自农村27例(62.8%)。男性38例(57.6%);单、双眼分别为50(75.8%)、16(24.2%)例。初诊51例(77.3%),复诊15例(22.7%)。初诊51例中,平均就诊年龄(20.9±14.4)个月;单、双眼患儿平均就诊年龄分别为(23.2±14.7)、(11.2±7.6)个月。可明确病程及就诊原因41例,患儿平均病程(90.6±115.2)d。瞳孔区发白32例(62.7%),眼部红肿4例(9.8%),其他原因5例(12.2%)。复诊15例中,平均就诊年龄为(63.6±46.8)个月;平均病程(32.8±45.5)个月。复发、手术后并发症分别为5(33.3%)、3(20.0%)例;瞳孔区发白4例(26.7%);眼球突出、眼部红肿分别为2(13.3%)、1(6.7%)例。82只眼中,入院治疗50只眼;其中,初诊37只眼,复诊13只眼。初诊37只眼中,眼内期31只眼(83.8%),包括A^C期5只眼(13.5%)、D^E期26只眼(70.3%);眼外期6只眼(16.2%)。A^C期5只眼均行激光光凝和(或)冷冻联合全身化学药物治疗(化疗);D期4只眼行眼动脉介入化疗;其余D^E期22只眼、眼外期6只眼中,行眼球摘除、眶内容物剜除手术分别为19(51.3%)、2(5.4%)只眼,放弃治疗7只眼(18.9%)。复诊13只眼中,既往已行眼球摘除6只眼(46.2%),其中手术后复发5只眼;眼外期4只眼(30.8%);D^E期3只眼(23.1%)。行眶内容物剜除、眼球摘除手术分别为5(38.5%)、4(30.8%)只眼;行眼整形手术1只眼(7.7%);放弃治疗3只眼(23.1%)。入院治疗患儿保眼率为18.0%,眼内期保眼率29.0%,眼外期保眼率0.0%。结论西南地区RB患儿就诊时病程长、分期晚、保眼率低。     

眼科手术或联合系统化学疗法治疗视网膜母细胞瘤的短期观察

观察视网膜母细胞瘤（RB）患者全身化学药物治疗联合局部治疗的临床效果。方法回顾分析2006年8月至2007年9月本院收治的68例84只眼行全身化疗联合局部治疗并随访3个月以上的RB患儿的临床资料。所有患儿均进行眼部超声（B型超声或彩色多普勒超声）、影像学（CT/MRI）以及眼底照相检查（RetCam婴幼儿眼底照相机）,确诊为RB的患儿共66例82只眼,双眼16例,单眼50例;男性36例,女性30例。按照国际眼内视网膜母细胞瘤分期（IIRC）系统分期,A期选择局部治疗（包括激光光凝和冷冻疗法）,B、C、D、E期在系统化疗（CCTV方案,环孢霉素、卡铂、替尼泊苷、长春新碱）的基础上,联合手术（包括局部治疗、眼球摘除和眶内容剜出）治疗。随访时间6~13个月,平均8.6个月。结果 按IIRC分期,A期5只眼,B期6只眼,C期5只眼,D期15只眼,E期51只眼（包括球外转移的）;治疗结束后22只眼得以保存,其中,A~E期分别为5、6、5、4、2只眼,分别占同期治疗眼的100%、100%、100%、26.7%、3.9%;死亡5例,均为E期患者,占总人数的7.6%。结论 眼科手术或联合系统化学治疗RB是有效的,其疗效与患者肿瘤的临床分期有关,A、B、C期患者治疗效果较好,D、E期次之。     

应用广角数码儿童视网膜成像系统联合局部治疗早期视网膜母细胞瘤

目的分析早期视网膜母细胞瘤(Rb)患儿局部治疗疗效。方法对2009年至2012年收治的12例(12只眼)早期Rb患儿(均为低风险的A/B期)采用激光光凝、冷冻相结合的局部治疗,对其疗效进行临床分析。结果患儿总的生存率和保眼率为100%(12/12),所有患儿的肿瘤全部萎缩钙化,未见新发肿瘤灶,治疗后患儿无严重眼部或全身并发症。患儿采取的相应治疗措施由肿瘤的具体位置和大小决定。结论 A、B期Rb患儿的治疗预后好,早期诊断是关键,吸入麻醉下的RetCam成像联合局部光凝或冷凝干预是早期Rb患儿有效的治疗手段。     

视网膜母细胞瘤的治疗进展

当前对视网膜母细胞瘤(RB)的治疗方法包括化学减容法(chemoreduction)、经瞳孔温热疗法(TTT) 、冷冻疗法、激光光凝、巩膜敷贴放射治疗、外照射放射治疗、眼球摘除、眶内容剜除和全 身化学治疗。近年来，对于单眼为Reese-Ellsworth V级肿瘤的患者行眼球摘除术、I～IV级的患眼则采用化学减容法或局部治疗方法；对于大部分双眼RB患者采用化学减容治疗，而对双眼病变程度极不对称的病例，在摘除高度进展患眼后，肿瘤较小的对侧眼常采用保守的局部治疗。（中华眼底病杂志，2004，20：194-197）     

化学减容术联合局部疗法治疗眼内晚期视网膜母细胞瘤的近期疗效观察

目的:察化学减容术联合眼肿瘤局部加强治疗方法治疗晚期眼内 视网膜母细胞瘤 的疗效。 方法:对9例13只视网膜母细胞瘤（RB）患眼采用化学减容术联 合眼肿瘤局部冷冻和(或)经瞳孔温 热 疗法（TTT）进行治疗，并对其临床随访资料进行回顾性分析。化学减容术采用长春新碱， 卡铂和依托箔苷（VEC）方案。平均随访时间15.3个月。 结果：所有13只患 眼均对化学减容术显 示出良好初始反应。经第一疗程化疗后，肿瘤基底最大直径平均缩小37.2%；肿瘤厚度平均 缩小46.7%。6只眼视网膜下积液部分或完全吸收，10只眼视网 膜下肿瘤种植明显减少、消失或钙化，11只眼玻璃体内肿瘤种植明显减少、消失或钙化。治疗期间及治疗后随访期间共有8只眼出现了肿瘤和(或)肿瘤 种植的复发和(或)新发，经补充冷冻和(或)TTT治疗后，最终2只眼（2/13）摘除，11只眼 得以保留，其中8只眼恢复或保持较好有用视力。9例患者均未发生白血病、肝肾功能及听力 损害等严重化学治疗毒性反应。 结论：对高度进展的晚期RB，化学减容术在治疗初期显示了良好的初始反 应。化学减容术联合眼肿瘤局部加强疗法近期内可有效控制视网膜肿瘤、视网膜下种植及 玻璃体内种植； 远期疗效有待继续观察。     

Late presentation of bilateral retinoblastoma: case report

A case of retinoblastoma with uncommon features is reported, aiming at improving follow-up. In 1993, SJMMF, 9-month-old white boy, presented a squint in the left eye. A retinal tumor was detected. The patient had a family history of retinoblastoma. Enucleation was performed and retinoblastoma was proved. The patient underwent examination for staging, all were normal. The fellow eye remained normal for 10 years. During routine examination the retina map revealed three retinoblastoma white lesions in the nasal retina. The patient underwent transpupillary thermotherapy with diode laser. After 30 days, the lesions became atrophic. After 60 days there was tumor recurrence on the border of the lesion. Sclera cryotherapy was performed. There was tumor regression for six months. During follow-up, condensations next to the atrophic tumor lesions were discovered, which were vitreous seeds. Brachitherapy with 125 iodine was done. The lesions disappeared after 30 days. New vitreous seeds appeared 3 months later, set on the retina surface. They were blocked with sclera cryotherapy and transpupillary thermotherapy. The patient presented with new vitreous seeds after six months, which adhered to the retina. They were blocked with transpupillary thermotherapy. Follow-up was for 38 months since the appearance of the bilateral tumor. The patient presents normal visual acuity and clinical examination. This case is important considering the low frequency of the disease at this age. It is essential to maintain alertness when cases of retinoblastoma are seen as cured.     

Modern treatment of retinoblastoma: A 2020 review

Retinoblastoma management remains complex, requiring individualized treatment based on International Classification of Retinoblastoma (ICRB) staging, germline mutation status, family psychosocial factors and cultural beliefs, and available institutional resources. For this 2020 retinoblastoma review, PubMed was searched for articles dated as early as 1931, with an emphasis on articles from 1990 to the present day, using keywords of retinoblastoma, chemotherapy, intravenous chemotherapy, chemoreduction, intra-arterial chemotherapy, ophthalmic artery chemosurgery, intravitreal chemotherapy, intracameral chemotherapy, cryotherapy, transpupillary thermotherapy, laser, radiation, external beam radiotherapy, plaque radiotherapy, brachytherapy, and enucleation. We discuss current treatment modalities as used in the year 2020, including intravenous chemotherapy (IVC), intra-arterial chemotherapy (IAC), intravitreal chemotherapy (IvitC), intracameral chemotherapy (IcamC), consolidation therapies (cryotherapy and transpupillary thermotherapy [TTT]), radiation-based therapies (external beam radiotherapy [EBRT] and plaque radiotherapy), and enucleation. Additionally, we present a consensus treatment algorithm based on the agreement of three North American retinoblastoma treatment centers, and encourage further collaboration amongst the world''s most expert retinoblastoma treatment centers in order to develop consensus management plans and continue advancement in the identification and treatment of this childhood cancer.     

Low-power transpupillary thermotherapy combined with intravitreal triamcinolone acetonide for subfoveal choroidal neovascularization

PURPOSE: To examine transpupillary thermotherapy combined with intravitreal triamcinolone for treatment of subfoveal choroidal neovascularization. METHODS: The clinical interventional, noncomparative, case series study included 14 patients (14 eyes) with choroidal neovascularization (age-related macular degeneration, n = 11; high myopia, n = 2; unknown reason, n = 1), who underwent transpupillary thermotherapy (75-150 mW, 60 s, 500-3,000 microm), followed by an intravitreal triamcinolone injection (10 mg). Follow-up was at least 6 months. RESULTS: Visual acuity increased by 3 lines in 3 (21%) eyes at 3 months, and in 3 (21%) eyes at 6 months of follow-up. None of the patients experienced a visual acuity loss of 3 or more lines. At the 6-month follow-up, mean visual acuity was improved by 1.36 +/- 1.16 lines. Retreatment by transpupillary thermotherapy was performed for 3 (21%) eyes at 3 months, and for 1 (7%) eye at 6 months of follow-up. CONCLUSIONS: Transpupillary thermotherapy combined with intravitreal triamcinolone may be a therapeutic option for choroidal neovascularization particularly if other treatment modalities are not available.     

超选眼动脉化疗治疗视网膜母细胞瘤的临床观察

目的:通过对视网膜母细胞瘤(retinoblastoma,RB)患者实施眼动脉化疗,观察化疗效果及副反应。方法:根据RB最新国际分期,对11例11眼A~D期RB患者,通过股动脉插管至眼动脉,使用马法兰(melphalan)经眼动脉灌注,对RB患者实施动脉化疗。结果:所选患者共实施眼动脉灌注化疗23次,随访3~12mo,其中8例肿瘤明显缩小、钙化,2例病情进展,实施眼球摘除,1例失访。除部分患者术后短暂的恶心、呕吐、发热,没有出现死亡、中风、骨髓抑制等严重并发症。结论:所选患者中,A、B、C期9例,7例有效,1例继续进展,1例失访,有效率88%;2例D期患者1例有效,1例继续进展,有效率50%。     

Functional results after treatment of retinoblastoma.

PURPOSE: Because of the long-term complications associated with external beam radiation in retinoblastoma, alternative treatment methods have been investigated. We conducted a retrospective study to evaluate the functional results of new treatment modalities. METHODS: Thirty-seven eyes were treated without external beam irradiation in 31 patients. The median diameter of the largest tumor in each eye was 6 mm. Primary chemotherapy was used in 25 cases, chemothermotherapy was used in 32 cases, cryotherapy was used in 28 cases, iodine 125 Plaques were used in 15 cases, diode laser thermotherapy was used alone in 11 cases, and photocoagulation was performed in 5 cases. The median follow-up after diagnosis of retinoblastoma was 41 months. The visual results were evaluated at a median age of 54 months. RESULTS: The median visual acuity of the treated eyes was 20/33. Twenty-four eyes presented a visual acuity better than 20/40, 4 eyes had a visual acuity between 20/200 and 20/40, and 9 eyes had a visual acuity less than 20/200. Maculopathy was observed in 16 cases, associated with papillopathy in 1 case. A cataract was observed in 1 case and a vitreous hemorrhage was observed in another case. Twenty-one eyes did not develop any complications. No corneal dryness and very few lens changes were observed. CONCLUSION: The functional results after local treatments for retinoblastoma are very good. The most frequent complication is maculopathy, particularly when the tumor involves or is situated close to the macula.     

Diode laser thermotherapy and chemothermotherapy in the treatment of retinoblastoma

INTRODUCTION: The use of transpupillary thermotherapy alone or associated with systemic chemotherapy is a therapeutic modality of ocular retinoblastoma that allows ocular preservation without external beam irradiation of the eye. We present our experience with thermotherapy in the treatment of selected cases of retinoblastoma. MATERIAL AND METHODS: This paper reports a retrospective case series of patients treated for retinoblastoma by thermotherapy or chemothermotherapy (carboplatin IV followed by thermotherapy) in a single institution from October 1994 to December 2000. Data collected include general characteristics of the treated children, tumor characteristics, and the results of the treatments on local tumor control. Transpupillar thermotherapy was delivered with a diode laser through an operating microscope. Each tumor was treated separately and laser intensity, spot size, and duration were adapted to the size of the tumor and the clinical response. Chemothermotherapy consisted in thermotherapy delivered shortly after an intravenous injection of carboplatin (560 mg/m(2)) at day 1, followed by thermotherapy alone at day 8 if the lesion was 6mm or more in diameter. This cycle was administered every 28 days. The choice between thermotherapy and chemothermotherapy depended on the initial size of the lesions. Thermotherapy was used when the lesion measured 3mm or less. Lesions measuring more than 15 mm, or associated with substantial vitreous seeding, retinal detachment, or optic nerve head involvement are not suitable for these techniques. RESULTS: During the study period, 239 children were treated in our institution and 109 of them (147 eyes, 372 tumors) could be treated conservatively without external beam radiation. The median tumor diameter at the moment of thermotherapy or chemothermotherapy was 2mm (range, 0.2-15.0mm). One hundred and ninety-four tumors were treated by chemothermotherapy and 18 by thermotherapy alone. In 75% of the cases, the treatment was administered after two courses of chemotherapy (etoposide and carboplatin). After a mean follow-up of 55 months (range, 16-89 months), tumor control was obtained in 87.1% of lesions after chemothermotherapy and 77.8% after thermotherapy. Salvage enucleation was necessary for seven lesions (seven eyes) but none in the cases where thermotherapy was used alone. No severe systemic side effects were noted. DISCUSSION: Diode laser delivers hyperthermia on the tumor bed and its use alone or in association with systemic administration of carboplatin makes it possible to preserve the eye without external beam irradiation, with few side effects and less cumulative doses of chemotherapy. CONCLUSION: Thermotherapy and chemothermotherapy provide excellent local tumor control and eye preservation in selected cases of retinoblastoma.