How we approach conservative treatment of retinoblastoma in South America in the era of local ocular treatments: A consensus of the Grupo America Latina de Oncologia Pediatrica (GALOP)

Abstract

Local therapies are increasingly used for ocular preservation in retinoblastoma. In middle‐income countries, these techniques pose specific challenges mostly related to more advanced disease at diagnosis. The Grupo de America Latina de Oncología Pediátrica (GALOP) developed a consensus document for the management of conservative therapy for retinoblastoma. Intra‐arterial chemotherapy (OAC) is the preferred therapy, except for those with less advanced disease or age younger than 6 months. OAC allowed for a reduction in the use of external beam radiotherapy in our setting. Intravitreal chemotherapy is the preferred treatment for vitreous seeding. Enucleation is the treatment of choice for eyes with advanced disease.

Intra‐arterial chemotherapy for retinoblastoma: Centralization of care is essential

“…In fact, this can be a challenge for countries with a small number of cases, so organizations like the European Retinoblastoma Group (EURbG) and the Latin American Group for Pediatric Oncology (GALOP) recommend performing this procedure in centers with high numbers. 12 In small countries, this would mean referring patients cross-border if necessary but not starting a new program if a low patient number is expected. For large centers already performing intra-arterial chemotherapy that have passed the learning curve, it is important to have a team of interventional neuroradiologists or neurosurgeons who are appropriately trained and not rotated with others with less training in this procedure.…”