Chemotherapy

Chemotherapy, also simple called chemo, is a cancer treatment that involves killing cancer cells through the use of certain chemicals. Chemotherapy is typically taken as a pill or injected into a blood vessel. Each child’s chemotherapy plan will depend on his or her specific retinoblastoma case, including the size, location, and stage of the cancer. Chemotherapy is typically administered in cycles to allow the body time to recover in between doses.

Types of Retinoblastoma Chemotherapy

The type of chemotherapy administered will depend on each patient’s pediatric retinoblastoma case. Before determining how to administer chemotherapy, the pediatric oncologist will determine factors. These factors include the size, stage, and scope of the retinoblastoma tumors. In most cases, systemic chemotherapy is used. Systemic chemotherapy uses a pill or injection to reach the patient’s entire body. Other forms of pediatric retinoblastoma chemotherapy are more localized around the eye.

Periocular Retinoblastoma Chemotherapy

Periocular, or subtenon, chemotherapy may be used for more advanced cases of pediatric retinoblastoma. Periocular chemotherapy is often given in conjunction with systemic chemotherapy. During periocular chemotherapy, an anti-cancer drug called carboplatin is injected into the patient’s eye tissues when the patient is under general anesthesia. The drug then diffuses into the patient’s eye.

Intra-arterial Retinoblastoma Chemotherapy

Intra-arterial chemotherapy is a newer form of treatment for pediatric retinoblastoma. Intra-arterial chemotherapy involves localized injection into the ophthalmic artery. The ophthalmic artery is the main artery which supplies the eye with blood. During intra-arterial chemotherapy, a thin catheter, or hollow tube, is inserted through a large artery located in the inner thigh. The catheter is then threaded through blood vessels and into the ophthalmic artery. Due to the direct application of chemotherapy to the eye, intra-arterial chemotherapy allows for significantly smaller doses of chemotherapy drugs.

Retinoblastoma treatment often includes a combination of two or three of the following drugs:

• Cisplatin
• Carboplatin
• Vincristine
• Teniposide
• Etoposide
• Doxorubicin
• Cyclophosphamide

Retinoblastoma Chemotherapy Uses

Chemotherapy for can be used to treat different states and stages pediatric retinoblastoma. A process called chemoreduction is used to shrink retinoblastoma tumors before they spread outside of the child’s eye. Other types of therapy may assist this treatment, such as cryotherapy, thermotherapy, or laser therapy.

Spread of Retinoblastoma

Systemic chemotherapy is often used when retinoblastoma has spread from the eye, or seems likely to have spread based on the location and size of the cancer. When the cancer spreads becomes more critical. In cases where pediatric retinoblastoma spreads to the child’s brain, chemotherapy may be injected into the fluid surrounding the brain.

Retinoblastoma Chemotherapy Side Effects

The side effects children will experience from retinoblastoma chemotherapy will typically depend on the type of drug used. For example, carboplatin and cisplatin may affect the patient’s kidneys. Vincristine may damage nerves and cause side effects such as numbness or tingling in the hands and feet. Doxorubicin may cause heart damage. Cyclophosphamide may cause bladder damage, which can result in blood in the urine.

General chemotherapy side effects may include:

• Loss of appetite
• Fatigue
• Nausea and vomiting
• Diarrhea
• Mouth sores
• Hair loss
• Increased infection
• Ease of bleeding or bruising