title: The clinical outcomes of proton beam radiation therapy for retinoblastomas that were resistant to chemotherapy and focal treatment.
abstract: OBJECTIVE
  To evaluate the clinical results of proton beam radiation therapy (PBRT) for treatment of retinoblastoma.
  
  
  METHODS
  Children with retinoblastoma who were treated with chemotherapy and focal treatment such as brachytherapy and thermotherapy but showed no response or developed recurrences later received PBRT. The PBRT strategy was designed to concentrate the radiation energy to the retinoblastoma and spare the surrounding healthy tissue or organs.
  
  
  RESULTS
  There were three patients who received PBRT. The first patient received PBRT because of an initial lack of tumor regression with chemotherapy and brachytherapy. This patient showed regression after PBRT. The second patient who developed recurrence of retinoblastoma as diffuse infiltrating subretinal seeding was taken PBRT. After complete regression, there was recurrence of tumor and the eye was enucleated. The third patient had unilateral extensively advanced retinoblastoma. Initial chemotherapy failed and tumor recurred. The tumor responded to PBRT and regressed significantly. However, the eye developed sudden multiple recurrences, so we had to perform enucleation.
  
  
  CONCLUSIONS
  PBRT for retinoblastoma was effective in cases of showing no response to other treatment modalities. However, it should be carefully applied when there was recurrence of diffuse infiltrating subretinal seeding or extensively advanced retinoblastoma initially.
authors: Department of Ophthalmology, Inje University Ilsan Paik Hospital, Goyang, Korea.
authors: Ji Woong
authors: JW
authors: Chang
authors: Young Suk
authors: YS
authors: Yu
authors: Joo Young
authors: JY
authors: Kim
authors: Dong Ho
authors: DH
authors: Shin
authors: Jin
authors: J
authors: Choi
authors: Jeong Hun
authors: JH
authors: Kim
authors: Seong-Joon
authors: SJ
authors: Kim
mesh_terms: D002675:Child, Preschool; D003131:Combined Modality Therapy; D004351:Drug Resistance; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D019572:Retinal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery; D012175:Retinoblastoma / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome