Retinoblastoma: External Beam Radiation

In the treatment of retinoblastoma, radiation therapy provides a useful historical benchmark for the evaluation of tumor control, eye preservation, and side effects. The National Cancer Institute’s SEER data demonstrates that upfront radiotherapy was utilized in 34.6% of patients from 1985 to 1989 and declined to 6.5% from 2000 to 2004. Due to the haunting potential of long-term side effects, its role has recently been replaced by a move towards chemotherapy, most recently ophthalmic artery chemosurgery combined with intravitreous chemotherapy injections (Chap. 13 ). This chapter will discuss external beam radiation therapy and its indications, risks, and new delivery approaches. Chapter 11 provides more detail about brachytherapy in the treatment of intraocular retinoblastoma.