Simultaneous bilateral radiation for advanced bilateral retinoblastoma.

A retrospective review of 1,424 cases of retinoblastoma disclosed 34 patients with advanced bilateral retinoblastoma whose sole initial treatment was simultaneous bilateral radiation. All patients had a combination of bilateral group IV or V retinoblastoma. Mean age at diagnosis was 13.1 months. Five-year survival of patients was 88% (28/32). In two (7%) of 28 surviving patients, a second nonocular tumor developed: one inside and one outside the field of radiation. Of the 64 eyes treated, 44 ultimately were enucleated. Of ten eyes requiring a second course of radiation, nine were enucleated. In only one eye was enucleation due to radiation complications. Eleven patients required additional treatment with light coagulation, cryopexy, or cobalt plaques.