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Correspondence to Author: Gabriel Queiroz Sabbag¹, Marcus Baia Fonseca²,Isabella Pereira Lério², Rafaela Gonçalves Bueno³, Bárbara Leitão³, Isabela Marini Ferreira⁴, Giovana Casarini Yamashiro⁴, Bruno Fiorio Pinheiro⁵,; Marcos Brizola², Mariana Machado Regonha², Aghata Cruz Abreu², Gabriel Leonardo Saraiva², Jenyffer Victoria Cabrera Villca ², Adriana F. Viana ², Thiago Augusto Rochetti Bezerra^2-6, Rubens Rodrigues Tudela⁷, Joel Eloi Belo Junior⁸, Hamilton Roberto M.de Oliveira Carriço¹⁰, Délio Tiago Martins Malaquias^2-9. 

1. Medical degree from São Leopoldo Mandic Araras, São Paulo. Resident in Ophthalmology
2. Medical student. Ribeirão Preto University (UNAERP), Guarujá. São Paulo, Brazil.
3. Medical student. Professor Franco Montoro Municipal College. Mogi Guaçu, São Paulo.
4. Medical student. Nove de Julho University. São Bernardo do Campo, São Paulo, Brazil.
5. Medical student. Municipal University of São Caetano do Sul, São Paulo, Brazil.
6. Doctor of Medical Sciences. University of São Paulo (USP), Ribeirão Preto Medical School (FMRP). Ribeirão Preto, São Paulo, Brazil.
7. Medical student. São Judas Tadeu. Cubatão, São Paulo, Brazil.
8. Master’s degree in Operational Human Performance. Master’s student in Intellectual Property and Technology Transfer for Innovation.
9. Graduated in Physiotherapy from the University of Mogi das Cruzes; Postgraduate in Respiratory Physiotherapy and Pediatric Intensive Care and Neonatology from the University of São Paulo, São Paulo/SP, Hospital Physiotherapy, Bahiana School of Medicine and Public Health. Salvador/BA, Brazil.
10. Medical student. University of Southern Santa Catarina. Tubarão, Santa Catarina. Brazil

DOI: 10.52338/tejoc.2025.4868

Abstract:

Retinoblastoma is the most common malignant intraocular tumor of childhood, with important implications for the child’s survival and quality of life. Historically treated by enucleation and external radiotherapy, the management of the disease has evolved significantly with the advent of chemotherapy, which has become a more conservative and effective alternative. This systematic review with meta-analysis aimed to compare the efficacy and safety of the three main chemotherapy approaches currently used in the treatment of childhood retinoblastoma: systemic intravenous chemotherapy (ISCT), intra-arterial chemotherapy (IAQ) and intravitreal chemotherapy (IVCT). 28 studies were included with a total of 3,765 patients and 4,892 eyes treated. The results showed superiority of IAQ and IVQ over ISQ in terms of tumor regression (82.1% and 88.5% versus 62.4%, respectively) and ocular preservation (73.6% and 79.1% versus 54.2%). In addition, the incidence of systemic complications was significantly lower in localized therapies, especially in IVF (2.8%). The discussion based on the scientific literature showed that these locoregional approaches, as well as being more effective, have greater potential for preserving vision and reducing side effects. The conclusion is that the choice of therapeutic approach should take into account tumor staging, the anatomical characteristics of the affected eye and advances in personalized medicine, with a focus on quality of life and long-term visual function.

Keywords:retinoblastoma, intra-arterial chemotherapy, intravitreal chemotherapy, pediatric oncology, ocular preservation, individualized treatment.

Citation:

Dr. Thiago Augusto Rochetti Bezerra, Chemotherapy Approaches in the Treatment of Childhood Retinoblastoma: Comparison of Intravenous, Intra-arterial and Intravitreal Therapies. The European Journal of Cancer 2025.