New method designed to save vision of children with retinoblastoma

Doctors may be able to save the eyes of children with retinoblastoma by using a plaque method, according to an ophthalmologist at Washington University School of Medicine in St. Louis.

J. William Harbour, MD, professor of cell biology and molecular oncology and director of ocular oncology at the Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, explained that the standard of care for retinoblastoma is chemotherapy, followed by laser and freezing treatments to eliminate the last traces of tumors. However, an occasional tumor doesn't respond to treatment or is too large to treat via laser or freezing methods.

In an attempt to save the eyes of two pediatric patients with retinoblastoma, Dr. Harbour conducted surgical therapy using a small disc, or treatment plaque, which stays in the eye for 3 days before a second surgery to remove it. Each plaque contains seeds that are designed to deliver radiation directly to the tumor cells.

“The radiation causes damage within the cancer cells that prevents them from proliferating and spreading,” Dr. Harbour stated. “By the time we take off the plaque, the cancer cells are either dead or mortally wounded, even though we do not immediately see a difference in the appearance of the tumor. After the plaque therapy, as the cancer cells try to proliferate and divide, those cells die, which we then notice in follow-up exams as the tumor shrinks over time.”

According to Dr. Harbour, because the radiation gets to the tumor in a much more focused way than was possible in the past, it is less likely that the plaques will contribute to future problems in or around the eye.

Dr. Harbour explained that he still begins retinoblastoma treatment with chemotherapy, but when tumors are too big or unresponsive, the plaques provide a new option that has delivered positive results.

According to the press release announcing the new procedure, in the United States, retinoblastoma is diagnosed in about 200 children each year.

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