Some Children with Eye Cancer Can Avoid Chemotherapy

French researchers have found that some children with low-

risk retinoblastoma who are treated with surgery can safely 

skip post-surgery chemotherapy without the disease returning 

or spreading. And those with intermediate- or high-risk 

retinoblastoma can undergo a less aggressive chemotherapy 

treatment.

Avoiding or reducing chemotherapy spares children from 

possible side effects. Some of the chemotherapy drugs used 

to treat retinoblastoma can have serious long term side 

effects including heart or nerve damage, hearing loss, and 

even a higher risk of developing leukaemia later on.

Retinoblastoma is a cancer of the retina, which is part of the 

eye. About 200 to 300 cases occur each year in the US. 

Almost all retinoblastoma patients are very young children; 

the average age at diagnosis is 2. More than 90% of patients 

are cured.

Retinoblastoma can occur in one or both eyes. The study 

looked at children who had the cancer in one eye who were 

treated by having the eye surgically removed. Chemotherapy 

is sometimes given after surgery in these cases when the 

tumour extends into other parts of the eye, making it possible 

the cancer has spread.

The study included 123 children who were classified as low-

risk, intermediate-risk, or high-risk, depending on the extent 

of the tumour within the eye. The 70 children with low-risk 

retinoblastoma received no chemotherapy after surgery. The 

52 children with intermediate-risk retinoblastoma received 4 

courses of chemotherapy after surgery, and the only child 

with high-risk retinoblastoma received 6 courses of 

chemotherapy after surgery.

Researchers followed the children for an average of almost 6 

years. At the end of the follow-up period, none of the children 

had any worsening, spreading, or return of the cancer.

The study’s authors say their results demonstrate that it’s 

safe for low-risk retinoblastoma patients to go without post-

surgery chemotherapy, and suggest it could be safe for some 

intermediate-risk retinoblastoma patients to get a lower dose 

of chemotherapy, or perhaps even go without it.