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December 1997

What Is the Evidence Supporting Chemotherapy for Intraocular Retinoblastoma?-Reply

Author Affiliations

Los Angeles, Calif

Arch Ophthalmol. 1997;115(12):1605-1606. doi:10.1001/archopht.1997.01100160774027

In reply  Dr Hernandez addresses several issues we appreciate the opportunity to clarify. There are several clear reasons for using chemotherapy in addition to local modalities for RE group I and II tumors.1. In the RE classification, group I tumors are less than 4 disc diameters (6 mm) in greatest diameter and are located posterior to the equator. Cryotherapy is not recommended for tumors posterior to the equator.1 Traditional photocoagulation is recommended only for tumors no greater than 3 to 4 mm in diameter2 away from visually important retina. Most group I tumors occur in the posterior pole of young infants with a family history of retinoblastoma. Because of their posterior location, EBR, not cryotherapy or laser photocoagulation, has been the most common treatment.2 The risk of radiationinduced second malignant neoplasms in children younger than 1 year3,4 led us to search for an alternative to

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