I read with interest the article by Gallie et al1 in the November 1996 issue of the Archives regarding the use of chemotherapy in eyes with intraocular retinoblastoma.
Gallie et al describe a series of 40 eyes treated with focal therapy and chemotherapy—eyes that "conventionally should be enucleated or receive radiotherapy."1 However, 16 (40%) of these 40 eyes contained tumors that measured 10 disc diameters or less (Reese-Ellsworth [RE] classification I-II), which in other institutions would have been treated with focal treatment modalities alone (laser therapy, cryotherapy, and plaque brachytherapy) if the macula was uninvolved. These patients would not have required external beam radiotherapy [EBR], much less enucleation. This discrepancy could be due to the unavailability of plaque brachytherapy in their institution, but this is not mentioned in the text; it is also not explained why the authors did not make this focal modality available to their patients
Hernandez JC. What Is the Evidence Supporting Chemotherapy for Intraocular Retinoblastoma?. Arch Ophthalmol. 1997;115(12):1604. doi:10.1001/archopht.1997.01100160774025