Question

Enumerate indications for intra-arterial chemotherapy in the management of retinoblastoma.

Hint:

Intra-arterial chemotherapy is especially beneficial in cases of advanced or bilateral retinoblastoma, where vision preservation is a key concern.

Answer 1

Step 1: Indications for Intra-Arterial Chemotherapy:
Intra-arterial chemotherapy (IAC) is primarily used in the treatment of retinoblastoma when the tumor is not amenable to conventional treatments like enucleation or external beam radiation. Indications include:
1. Unilateral Retinoblastoma: In cases where the tumor is localized and involves one eye, IAC can help preserve vision.
2. Bilateral Retinoblastoma: In bilateral cases, IAC is often used to treat tumors in both eyes to avoid enucleation and preserve vision in at least one eye.
3. Recurrent or Residual Tumors: IAC is considered when there is recurrence or residual tumor after initial chemotherapy.
4. Advanced Retinoblastoma: In advanced stages where the tumor has invaded the optic nerve or retina, IAC helps to shrink the tumor and prevent further spread.