Traitement du rétinoblastome et résultats - Lausanne 1963-1989

Abstract

97 cases of retinoblastoma were studied with particular attention to methods of treatment and results. The series includes 41 unilateral cases (42%) and 56 bilateral cases (58%), giving a total of 153 eyes. Of these, 19 (20%) were familial cases. Immediate enucleation was necessary in 88 of the 153 eyes; 61 eyes received conservative treatment; 4 eyes, including one bilateral case, showed spontaneous recovery (retinomas). Conservative treatment consisted of high-voltage external beam irradiation in 43 cases, cryo or photocoagulation in 12 cases, and radioactive applicators in 6 cases. The mortality-rate in cases with over 2-years follow up is of 11%. In 65% of treated cases the eye was saved, with 87% of these retaining useful or central vision. The most serious complications are radiation retinopathy (19%), cataract (16%) and exsudative retinal detachment (9%).

200 years of success initiated by James Wardrop’s 1809 monograph on retinoblastoma

“…It is easy to understand that ophthalmologists were keen to manage retinoblastoma with radiotherapy as soon as this modality became available, ushering in the era of organ preservation. Luckily, as a rapidly growing tumour, retinoblastoma proved to be highly sensitive to radiation, and it was among the first tumours to be cured by x-rays in 1903 (Balmer et al 2003). By 1926, enucleation had been accepted as standard treatment for unilateral retinoblastoma and radiotherapy was widely used to avoid bilateral enucleation (Morax 1926).…”

“…By 1926, enucleation had been accepted as standard treatment for unilateral retinoblastoma and radiotherapy was widely used to avoid bilateral enucleation (Morax 1926). The final step was development of plaque brachytherapy for this tumour (Balmer et al 2003).…”