Purpose: To study the role of external beam radiation therapy (EBRT) for the treatment of retinoblastoma eyes that were not cured by combined systemic chemotherapy and focal consolidation therapy.Methods and Materials: A retrospective case series of 28 eyes for 24 retinoblastoma patients treated by EBRT after the failure of tumor controlled by chemotherapy and focal therapy. The main outcome measures included: international intraocular retinoblastoma classification stage (IIRC) and Reese Ellsworth (RE) stage, tumor seeding, treatment modalities, eye salvage, and survival.Results: The median age at diagnosis was 11 months. There were 14 (58%) males and 20 (83%) bilateral cases. All eyes were treated initially by systemic chemotherapy (range; 6-8 cycles). The dose of radiation used for all eyes was 45 Gray (Gy).The mean follow-up was 75months, and the overall eye salvage rate after EBRT was 13 (46%) eyes: 67% (2/3) for IIRC group B, 71% (5/7) for group C, and 33% (6/18) for group D eyes. Vitreous seeds and tumor stage migration during management by chemotherapy were the most important significant predictive factors for tumor control (p = .001 and 0.033, respectively).Conclusion: Eyes with retinoblastoma that failed chemotherapy followed by focal therapy were controlled with EBRT. However, the presence of vitreous seeds, stage migration during the course of chemotherapy, as well as good vision in the other eye may not justify the known risks of EBRT.

中文翻译：

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化学还原法和局灶性巩固疗法失败后外照射对视网膜母细胞瘤的作用。

目的：探讨外照射疗法（EBRT）在系统性化学疗法与局灶性巩固疗法联合治疗后未治愈的视网膜母细胞瘤眼中的作用。方法与材料：回顾性病例系列，共28眼，治疗24例视网膜母细胞瘤患者。肿瘤衰竭后的EBRT可通过化学疗法和局灶疗法控制。主要结果指标包括：国际眼内视网膜母细胞瘤分类阶段（IIRC）和里斯·埃尔斯沃思（RE）阶段，肿瘤播种，治疗方式，挽救眼睛和生存期。结果：诊断中位年龄为11个月。男14例（58％），双侧病例20例（83％）。最初所有的眼睛都通过全身化学疗法治疗（范围； 6-8个周期）。所有眼睛的辐射剂量为45格雷（Gy）。平均随访时间为75个月，EBRT后的整体眼睛挽救率为13（46％）眼：IIRC B组为67％（2/3），C组为71％（5/7），D组为33％（6/18）眼睛。玻璃体种子和化学治疗过程中的肿瘤分期迁移是控制肿瘤的最重要的重要预测因素（分别为p = 0.001和0.033）。但是，玻璃体种子的存在，化疗过程中的阶段性迁移以及另一只眼的良好视力可能无法证明已知的EBRT风险。玻璃体种子和化学治疗过程中的肿瘤分期迁移是控制肿瘤的最重要的重要预测因素（分别为p = .001和0.033）。结论：视网膜母细胞瘤的化学治疗失败并随后接受局灶性治疗的眼睛是由EBRT控制的。但是，玻璃体种子的存在，化疗过程中的阶段性迁移以及另一只眼的良好视力可能无法证明已知的EBRT风险。玻璃体种子和化学治疗过程中的肿瘤分期迁移是控制肿瘤的最重要的重要预测因素（分别为p = .001和0.033）。结论：视网膜母细胞瘤的化学治疗失败并随后接受局灶性治疗的眼睛是由EBRT控制的。但是，玻璃体种子的存在，化疗过程中的阶段性迁移以及另一只眼的良好视力可能无法证明已知的EBRT风险。