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New standard of care for retinoblastoma

February 18, 2011

There’s a new standard of care for children suffering from advanced retinoblastoma, a cancerous tumour of the eye, thanks to a recent study out of SickKids.

The study, done in conjunction with Princess Margaret Hospital (PMH) in Toronto and Beijing Tongren Hospital, analyzed 100 cases in China where the child’s eye had been removed. The researchers found that children were more likely to survive the disease if the affected eye was removed immediately without undergoing chemotherapy treatment first. Of the patients who had chemotherapy that delayed the surgical removal of the eye to more than three months after diagnosis, nearly 17 per cent died.

According to Dr. Brenda Gallie, an ophthalmologist at SickKids and the lead researcher on the study, chemotherapy can mask the spread of the disease, undetected, past the eye and into the brain.

“We are thinking about saving the whole child – not just the eye,” says Gallie, who is also a senior scientist at the Campbell Family Institute for Cancer Research, Ontario Cancer Institute at PMH. “Our research reinforces the importance of removing a severely affected eye without delay. Often when only one eye is affected, early surgery is the only necessary treatment.”

As a worldwide leader in the diagnosis and treatment of retinoblastoma, SickKids has a one per cent mortality rate for patients with the disease. While many other hospitals chose to treat the patient with chemotherapy, early eye removal has been the standard of care for SickKids. But with these recent findings, many other hospitals may now follow the lead of SickKids.

This study is the largest of its kind with a retrospective analysis of patients in China between May 2006 and October 2008. China is second in the world for new retinoblastoma cases, mainly due to its large population size. The study found there were no deaths when the eye was removed promptly after diagnosis.

Retinoblastoma can be inherited and is difficult to detect. In more than 70 per cent of cases, the first sign of disease is when a photo of the child reveals a white glow in the eye – known as cat eye – where red eye would normally appear.

The study is supported by the Ontario Ministry of Health and Long-Term Care, Kalmar Family Trust, the Canadian Retinoblastoma Society and SickKids Foundation.

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