Treatment of Non-Germline Unilateral Retinoblastoma — ICRB Group B (Macular Involvement) through Group E, Without High-Risk Features

This protocol is designed for patients with non-germline, unilateral retinoblastoma classified as ICRB Group B with macular involvement, or Group C, D, or E — where extraocular extension, choroidal invasion, and optic nerve invasion are absent.

Clinical Scenario

Non-germline unilateral retinoblastoma, ICRB Group B with macular involvement or Group C, D, or E, without high-risk pathological features (no extraocular extension, no choroidal or optic nerve invasion). Intra-arterial chemotherapy (IAC) is the preferred primary approach for this unilateral presentation.

Treatment Approach (Partial)

Management involves intra-arterial chemotherapy (IAC) delivered supraselectively into the ophthalmic artery, combined with focal consolidation techniques. The specific drug selection and regimen complexity are tailored to the ICRB stage — details of the stage-adapted protocol, including agent choice and adjunctive measures, are in the full structured regimen.

Treatment Goals

Regression of the tumor, reattachment of the retina, and formation of a calcified scar.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.4103/ijo.IJO_721_20

IAC is employed as primary therapy for non-germline, unilateral, group B, C, D, or E retinoblastoma or as a secondary therapy for unilateral or bilateral advanced recalcitrant disease facing enucleation.

Chemotherapy generally consists of one, two, or three drugs, typically delivered once a month for a mean of three sessions.

Focal therapies are often used for tumor consolidation in conjunction with IVC or IAC.

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