Retinoblastoma: Evolution of Treatment

Retinoblastoma management remains complex, requiring individualized treatment based on age at presentation, laterality, location, staging, compartmental involvement, vision potential, and available institutional resources. Standardization of therapy remains controversial because of the evolving nature of treatment and the lack of prospective studies or randomized trials. Even in developed nations, enucleation remains the definitive treatment for advanced unilateral intraocular retinoblastoma (Group E). The long-term burden of treatment, such as the need for multiple EUAs, ocular toxicity, and unpredictable visual outcome, should also be considered when discussing treatment options with the parents and pediatric oncologist.