A 3-year-old child with bilateral retinoblastoma undergoes examination under anaesthesia. The left eye has a single 4 mm tumor located between the equator and ora serrata without vitreous seeding. The International Classification of Retinoblastoma (IIRC) would classify this eye as Group B. Which treatment modality is most appropriate as primary therapy?
- A Intra-arterial chemotherapy alone
- B Enucleation
- C Systemic chemotherapy with focal consolidation (thermotherapy/cryotherapy) ✓
- D External beam radiotherapy
Correct answer: C. Systemic chemotherapy with focal consolidation (thermotherapy/cryotherapy)
Explanation
Group B retinoblastoma (larger or more posterior tumors without vitreous seeding) is treated with systemic chemotherapy (chemoreduction) combined with focal consolidation (thermotherapy or cryotherapy). Enucleation is reserved for Group E. Intra-arterial chemotherapy is an option for Group A and D. External beam radiotherapy is now rarely used due to secondary malignancy risk, particularly in heritable cases.
Reference: AAO BCSC Section 6: Pediatric Ophthalmology and Strabismus, 2022-2023 ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.