Author Affiliations: Department of Ophthalmology, University of Pennsylvania School of Medicine, Philadelphia (Drs Levin and O’Brien); and Department of Head and Neck Surgery, Section of Ophthalmology, MD Anderson Cancer Center, Baylor College of Medicine, Texas Children's Cancer Center, The Methodist Hospital Research Institute, The Retinoblastoma Center of Houston, Houston (Dr Gombos).
Beginning with the initial Hilgartner report1 in 1903 and culminating in the seminal Reese et al publication2 in 1954, external beam radiotherapy emerged as the first ocular salvage therapy in advanced retinoblastoma. The Reese-Ellsworth classification, based on tumor location, size, and multifocality, correlated well with the ocular response to lateral photon irradiation. Though effective in preventing enucleation in the majority of large retinoblastoma tumors, irradiation exposure unfortunately conferred a high risk of second cancers in children with heritable disease.3,4
Levin MH, Gombos DS, O’Brien JM. Intra-arterial Chemotherapy for Advanced RetinoblastomaIs the Time Right for a Prospective Clinical Trial?. Arch Ophthalmol. 2011;129(11):1487-1489. doi:10.1001/archophthalmol.2011.304