Bilateral retinoblastoma: successful conservative treatment of both eyes

Purpose: Conservative treatment (focal therapy, local and systemic chemotherapy, radiotherapy) is today the standard in Retinoblastoma treatment. Preservation of both eyes is unfortunately, not always , possible. Methods: . From 1959 to 2007, 442 cases of retinoblastoma have been diagnosed and treated at the Retinoblastoma Referral Center of the University of Siena. 175 cases were bilateral. Results: 25 out of 175 bilateral cases have been conservatively treated. Age at diagnosis, sex, hereditary, stage at diagnosis (Reese Classification and ABC Classification), remission patterns and therapeutic protocol are reported. The age at diagnosis ranged from 4 days to 15 months (mean age: 5.4 months). 8 out of 25 were females, 17 out 25 were males. 13 out of 25 were familial cases. Stage at diagnosis (50 eyes) was I in 16 eyes, II in 12 eyes, III in 8 eyes, IV in 11 eyes, V in 3 eyes. 25 out of 25 received chemotherapy and focal therapy according to the Italian protocol. 12 out of 25 relapsed. 9 out of 12 received new cycles of focal and chemotherapy. 2 out of 12 received also brachytherapy. In 2 out of 12 subconjuctival carboplatin has been used. In only 1 case (familial case)external radiotherapy was requested and the child died for a second tumor one year later. 5 out of 25 developed new foci, immediately treated only with focal therapy. Conclusions: The prognostic factors for successful conservative treatment are evaluated.