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Editorial |

Chemosurgery for Retinoblastoma:  What We Know After 5 Years

David H. Abramson, MD
Arch Ophthalmol. 2011;129(11):1492-1494. doi:10.1001/archophthalmol.2011.354.
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Superselective ophthalmic artery delivery of chemotherapy for retinoblastoma (“chemosurgery”) was initially performed just 5 years ago in an institutional review board–approved experimental protocol (for advanced eyes scheduled for enucleation) and was first reported in 2008.1 It has now been performed in 26 countries worldwide (Argentina, Australia, Brazil, Canada, China, Colombia, the Czech Republic, Egypt, France, Germany, Great Britain, Holland, India, Iran, Israel, Italy, Jordan, Korea, Pakistan, Russia, Slovakia, Spain, Switzerland, Thailand, Turkey, and the United States) and has subsequently been featured in a number of articles in the non–peer-reviewed literature, including stories in JAMA2 and the New York Times.3 Although some centers have almost completely abandoned primary radiation and/or systemic chemotherapy as a result of their experience with chemosurgery and claim a dramatic reduction in the need for enucleation,4 other centers have declined to perform the procedure.5 Concern has been raised about the absence of long-term data, about full knowledge of toxicity, and about other adverse issues.68 What do we really know about this approach?

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