Systemic for Retinoblastoma

Indications

• Tumors too large for laser therapy or cryotherapy.
  
• Good chance of saving eye and vision.
  
• Prevention of tumors in other parts of the body (i.e., metastasis) if risk is high, because the tumor in the eye has spread to optic nerve, uvea or orbit.
• Treatment of metastatic disease. 

Contraindications

• Small tumors treatable with laser therapy or cryotherapy.
• Very advanced tumor with only a small chance of saving the eye and vision.
• Advanced tumor if risk of retinoblastoma in other eye is very small.

Method

• The chemotherapy is administered through a Port-a-Cath implanted under the skin on the chest.
• Three drugs are usually given - carboplatin, etoposide and vincristine.
• The treatment is repeated every 3-4 weeks, giving 3 to 6 doses. 

Complications of Chemotherapy

• Any chemotherapy can cause anemia (thinning of the blood) and immunosuppression, so that the patient is predisposed to infections as well as hair loss, diarrhea and other side-effects. 
• The port-a-cath can become infected.
• Carboplatin can rarely cause hearing impairment.
• Etoposide can cause allergic reaction and, very rarely, leukemia.
• Vincristine can cause constipation.