Retinoblastoma is an intraocular malignant tumor occurring mainly in young children. In 75% patients, the disease is bilateral. Evolving from retinal cells, the tumor grows gradually into the vitreous body and orbit tissue. In severe cases, it invades the brain. Both conservative and surgical techniques are used to combat this pathology.
In the initial stages of the process, the sparing options for tumor removal are prescribed, which allow preserving the patient's vision. These include:
- Cryosurgery. This implies the retinoblastoma destruction by low temperature.
- Photocoagulation. Cancerous cell destruction by laser.
- Thermotherapy. The tumor is destroyed by ultrasound, infrared radiation, or microwave therapy.
All interventions are performed under general anesthesia. The method selection depends on retinoblastoma location. After the procedure, the child is subject to ongoing follow-up by the oncologist. In the event of relapse, the exposure is repeated.
At stage 2 or 3 of the disease, a combined treatment is prescribed. First the chemotherapy is conducted, which allows reducing the tumor size. Then the photocoagulation or cryotherapy is prescribed.
In European clinics, the local types of chemotherapy are preferred, which imply the injection of cytotoxic agents right into the eye tissue or their arterial supply. This approach helps to avoid the adverse influence on the child’s body.
Radiotherapy also shows a good outcome when combating the disease. Upon unilateral lesions, the radiation source is fixed to the eye surface (brachytherapy). If the tumor is bilateral with multiple foci, the remote manipulation is used. In this case, all eye tissue involved in the tumor process are irradiated.
For massive lesions and development of metastases, a surgical intervention is indicated, during which the eyeball and sometimes the orbit tissue is removed. Subsequently, a spherical prosthesis is installed in the place of the removed organ.
If both eyes of the patient are affected, only one of them is removed and the second is exposed to irradiation. Treatment is complemented with systemic chemotherapy, which prevents the relapse. Prescription of several cytostatic drugs with different mechanisms of action is the most efficient.