What treatment is considered for large tumors or moderately sized tumors in non-critical areas in patients with retinoblastoma?

The treatment of choice for large tumors or moderately sized tumors in non-critical areas for patients with retinoblastoma is the use of radioactive isotope plaques. This method, often referred to as plaque brachytherapy, involves placing a small radioactive source close to the tumor to deliver targeted radiation while sparing surrounding healthy tissue. This is particularly advantageous for larger tumors as it allows for effective treatment by delivering a high dose of radiation directly to the tumor.

Radioactive isotope plaque therapy is beneficial because it can help preserve vision in cases where enucleation (removal of the eye) would have otherwise been indicated. It is a less invasive option, allowing clinicians to tackle significant tumors without resorting to more drastic measures. The use of targeted radiation minimizes systemic side effects that could occur with chemotherapy, making it a preferable approach for select tumors.

In contrast, while treatments like enucleation, chemotherapy, and cryotherapy can be necessary depending on the situation, they are typically reserved for specific circumstances. Enucleation is mainly considered for extremely large tumors or when preservation of the eye and vision is not feasible. Chemotherapy is often used for systemic disease or to shrink tumors before other treatments. Cryotherapy is generally more suitable for smaller tumors that are easily accessible.

Therefore,