Retinoblastoma Consolidation in Egyptians
Retinoblastoma Consolidation: A Retrospective Multivariate Analysis In Egyptian Population
1 other identifier
observational
150
0 countries
N/A
Brief Summary
This analysis will evaluate the investigators' institution's specific experience using Ru-106 isotopes, cryotherapy, or transpupillary thermotherapy (TTT) to treat persistent or recurrent RB in patients who previously underwent systemic IVC or IAC. The investigators aim to detail the demographics, clinical indications, success rates-specifically local control and globe salvage-, predictive factors for success, and complications of each modality of treatment within a tertiary eye care setting in Egypt.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P50-P75 for all trials
Started May 2026
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
Click on a node to explore related trials.
Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
April 3, 2026
CompletedFirst Posted
Study publicly available on registry
April 15, 2026
CompletedStudy Start
First participant enrolled
May 1, 2026
ExpectedPrimary Completion
Last participant's last visit for primary outcome
May 1, 2027
Study Completion
Last participant's last visit for all outcomes
June 1, 2027
April 15, 2026
April 1, 2026
1 year
April 3, 2026
April 8, 2026
Conditions
Outcome Measures
Primary Outcomes (3)
Percentage of Globe salvage for treatment with Brachytherapy
The number of eyes that were not enucleated due to the success of brachytherapy in regressing the tumour in these eyes, compared to the total number of eyes that were treated with brachytherapy.
Baseline
Percentage of Globe salvage for treatment with cryotherapy
The number of eyes that were not enucleated due to the success of cryotherapy in regressing the tumour in these eyes, compared to the total number of eyes that were treated with cryotherapy.
Baseline
Percentage of Globe salvage for treatment with transpupillary thermotherapy
The number of eyes that were not enucleated due to the success of transpupillary thermotherapy in regressing the tumour in these eyes, compared to the total number of eyes that were treated with transpupillary thermotherapy.
Baseline
Interventions
The ERBE Erbokryo AE system is utilized to treat peripheral lesions. Before use, the probe must be tested for proper ice ball formation. Technique: Localization: Position the probe tip using indirect ophthalmoscopy and scleral indentation. Freezing: Center the tip under the tumor. The ice ball must extend 1-2 mm beyond the tumor apex to encompass potential vitreous seeds. Monitoring: Control the lateral spread to minimize damage to healthy retina. Cycles: Apply double or triple freeze-thaw cycles for maximum efficacy. Precautions: Limit treatment to 2-3 sites per session to reduce the risk of secondary serous or rhegmatogenous retinal detachment.
Plaque insertion is performed under general anesthesia. Precise tumor localization is achieved through simultaneous indirect ophthalmoscopy and transillumination; the tumor projection is marked on the sclera using blue ink. Muscles may be temporarily detached for proper seating. Planning and Dosimetry:Equipment: Ru-106 plaques (e.g., BEBIG) are used for tumors up to 7 mm thick and 17 mm in diameter.Dose: Following American Brachytherapy Society (ABS) guidelines, 90 gray (Gy) is delivered at 0.6-1.05 Gy/hr over 3-7 days.Margins: Calculation includes tumor height + 1 mm sclera. A 2-3 mm lateral margin and a 1 mm safety margin are maintained. Vitreous Seeds: Add 1 mm to the thickness calculation if local seeds are present.
The 810 nm red laser (Iridex Oculight SLx) is used via an indirect delivery system for transpupillary applications under general anesthesia. The goal is a gentle white spot at the tumor-retina boundary. Technique: Placement: Begin at the lesion edge, placing burns half-on and half-off the tumor. Titration: Increase power/duration until a reaction is seen. Punctate hemorrhage warns of maximum power density. Coverage: Create a perimeter with overlapping burns, then treat the entire lesion. Central thick areas may not whiten. Parameters: Set duration to 9000 milliseconds (ms) and interval to 50 ms for foot-pedal control (continuous mode). This allows for photocoagulation (1-10s) or thermotherapy (30-60s). Primary (Peripheral/Macular): Start at 300 milliwatt (mW). Chemoreduction (Large Tumors): Start at 400-500 mW; can increase to 800 mW with careful monitoring if no reaction occurs.
Eligibility Criteria
Medical records of Patients with RB who received Ru-106 plaque brachytherapy, cryotherapy, and/or TTT as salvage treatment after systemic intravenous chemotherapy (IVC) from October 2019 to April 2026
You may qualify if:
- Patients receiving secondary consolidation therapy with at least one year of post-treatment follow-up.
You may not qualify if:
- Incomplete data, extraocular or orbital RB at initial presentation, or follow-up duration under one year.
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Related Publications (33)
Broaddus E, Topham A, Singh AD. Incidence of retinoblastoma in the USA: 1975-2004. Br J Ophthalmol. 2009 Jan;93(1):21-3. doi: 10.1136/bjo.2008.138750. Epub 2008 Jul 11.
PMID: 18621794BACKGROUNDRodriguez-Galindo C, Wilson MW, Chantada G, Fu L, Qaddoumi I, Antoneli C, Leal-Leal C, Sharma T, Barnoya M, Epelman S, Pizzarello L, Kane JR, Barfield R, Merchant TE, Robison LL, Murphree AL, Chevez-Barrios P, Dyer MA, O'Brien J, Ribeiro RC, Hungerford J, Helveston EM, Haik BG, Wilimas J. Retinoblastoma: one world, one vision. Pediatrics. 2008 Sep;122(3):e763-70. doi: 10.1542/peds.2008-0518.
PMID: 18762512BACKGROUNDShields CL, Say EAT, Pefkianaki M, Regillo CD, Caywood EH, Jabbour PM, Shields JA. RHEGMATOGENOUS RETINAL DETACHMENT AFTER INTRAARTERIAL CHEMOTHERAPY FOR RETINOBLASTOMA: The 2016 Founders Award Lecture. Retina. 2017 Aug;37(8):1441-1450. doi: 10.1097/IAE.0000000000001382.
PMID: 27787452BACKGROUNDShields CL, Dockery PW, Yaghy A, Duffner ER, Levin HJ, Taylor OS, Sajjadi Z, Lally SE, Shields JA, Rosenwasser R, Tjoumakaris S, Jabbour P. Intra-arterial chemotherapy for retinoblastoma in 341 consecutive eyes (1,292 infusions): comparative analysis of outcomes based on patient age, race, and sex. J AAPOS. 2021 Jun;25(3):150.e1-150.e9. doi: 10.1016/j.jaapos.2020.12.006. Epub 2021 May 24.
PMID: 34044113BACKGROUNDKaliki S, Vempuluru VS, Mohamed A, Al-Jadiry MF, Bowman R, Chawla B, Hamid SA, Ji X, Kapelushnik N, Kebudi R, Sthapit PR, Rojanaporn D, Sitorus RS, Yousef YA, Fabian ID; Global Retinoblastoma Study Group. Retinoblastoma in Asia: Clinical Presentation and Treatment Outcomes in 2112 Patients from 33 Countries. Ophthalmology. 2024 Apr;131(4):468-477. doi: 10.1016/j.ophtha.2023.10.015. Epub 2023 Oct 13.
PMID: 37839559BACKGROUNDTomar AS, Finger PT, Gallie B, Kivela TT, Mallipatna A, Zhang C, Zhao J, Wilson MW, Brenna RC, Burges M, Kim J, Khetan V, Ganesan S, Yarovoy A, Yarovaya V, Kotova E, Yousef YA, Nummi K, Ushakova TL, Yugay OV, Polyakov VG, Ramirez-Ortiz MA, Esparza-Aguiar E, Chantada G, Schaiquevich P, Fandino A, Yam JC, Lau WW, Lam CP, Sharwood P, Moorthy S, Long QB, Essuman VA, Renner LA, Semenova E, Catala J, Correa-Llano G, Carreras E; American Joint Committee on Cancer Ophthalmic Oncology Task Force. Global Retinoblastoma Treatment Outcomes: Association with National Income Level. Ophthalmology. 2021 May;128(5):740-753. doi: 10.1016/j.ophtha.2020.09.032. Epub 2020 Sep 29.
PMID: 33007338BACKGROUNDHiasat JG, Saleh A, Al-Hussaini M, Al Nawaiseh I, Mehyar M, Qandeel M, Mohammad M, Deebajah R, Sultan I, Jaradat I, Mansour A, Yousef YA. The predictive value of magnetic resonance imaging of retinoblastoma for the likelihood of high-risk pathologic features. Eur J Ophthalmol. 2019 Mar;29(2):262-268. doi: 10.1177/1120672118781200. Epub 2018 Jun 11.
PMID: 29890860BACKGROUNDSchaiquevich P, Francis JH, Cancela MB, Carcaboso AM, Chantada GL, Abramson DH. Treatment of Retinoblastoma: What Is the Latest and What Is the Future. Front Oncol. 2022 Apr 1;12:822330. doi: 10.3389/fonc.2022.822330. eCollection 2022.
PMID: 35433448BACKGROUNDYousef YA, Al-Nawaiseh I, Mehyar M, Sultan I, Al-Hussaini M, Jaradat I, Mohammad M, AlJabari R, Abu-Yaghi N, Rodriguez-Galindo C, Qaddoumi I, Wilson M. How Telemedicine and Centralized Care Changed the Natural History of Retinoblastoma in a Developing Country: Analysis of 478 Patients. Ophthalmology. 2021 Jan;128(1):130-137. doi: 10.1016/j.ophtha.2020.07.026. Epub 2020 Jul 16.
PMID: 32682835BACKGROUNDYousef YA, Hajja Y, Nawaiseh I, Mehyar M, Sultan I, Deebajah R, Rawashdeh K, Khurma S, Jaradat I, Al-Hussaini M. A histopathologic analysis of 50 eyes primarily enucleated for retinoblastoma in a tertiary cancer center in Jordan. Turk Patoloji Derg. 2014;30(3):171-7. doi: 10.5146/tjpath.2014.01260.
PMID: 24913302BACKGROUNDServodidio CA, Abramson DH. Acute and long-term effects of radiation therapy to the eye in children. Cancer Nurs. 1993 Oct;16(5):371-81.
PMID: 8261386BACKGROUNDAbramson DH, Ellsworth RM, Rozakis GW. Cryotherapy for retinoblastoma. Arch Ophthalmol. 1982 Aug;100(8):1253-6. doi: 10.1001/archopht.1982.01030040231003.
PMID: 7103809BACKGROUNDShields CL, Mashayekhi A, Sun H, Uysal Y, Friere J, Komarnicky L, Shields JA. Iodine 125 plaque radiotherapy as salvage treatment for retinoblastoma recurrence after chemoreduction in 84 tumors. Ophthalmology. 2006 Nov;113(11):2087-92. doi: 10.1016/j.ophtha.2006.04.032. Epub 2006 Sep 1.
PMID: 16949158BACKGROUNDShields CL, Shields JA, Cater J, Othmane I, Singh AD, Micaily B. Plaque radiotherapy for retinoblastoma: long-term tumor control and treatment complications in 208 tumors. Ophthalmology. 2001 Nov;108(11):2116-21. doi: 10.1016/s0161-6420(01)00797-7.
PMID: 11713089BACKGROUNDPalkonda VAR, Ramachandran A, Adewara BA, Verma R, Raval V, Kaliki S. Ruthenium-106 (106Ru) plaque brachytherapy as salvage treatment for retinoblastoma following intravenous chemotherapy. Brachytherapy. 2025 Jan-Feb;24(1):76-85. doi: 10.1016/j.brachy.2024.06.008. Epub 2024 Nov 22.
PMID: 39580311BACKGROUNDSchipper J. An accurate and simple method for megavoltage radiation therapy of retinoblastoma. Radiother Oncol. 1983 Aug;1(1):31-41. doi: 10.1016/s0167-8140(83)80005-x.
PMID: 6438701BACKGROUNDYousef YA, Mohammad M, Jaradat I, Shatnawi R, Banat S, Mehyar M, Al-Nawaiseh I. The role of external beam radiation therapy for retinoblastoma after failure of combined chemoreduction and focal consolidation therapy. Ophthalmic Genet. 2020 Feb;41(1):20-25. doi: 10.1080/13816810.2020.1719519. Epub 2020 Feb 19.
PMID: 32072842BACKGROUNDFrancis JH, Barker CA, Wolden SL, McCormick B, Segal K, Cohen G, Gobin YP, Marr BP, Brodie SE, Dunkel IJ, Abramson DH. Salvage/adjuvant brachytherapy after ophthalmic artery chemosurgery for intraocular retinoblastoma. Int J Radiat Oncol Biol Phys. 2013 Nov 1;87(3):517-23. doi: 10.1016/j.ijrobp.2013.06.2045. Epub 2013 Aug 14.
PMID: 23953635BACKGROUNDYarovoy AA, Volodin DP, Yarovaya VA. A retrospective study on ruthenium-106 and strontium-90 eye-plaques treatment for retinoblastoma: 16-years clinical experience. Brachytherapy. 2025 Mar-Apr;24(2):265-272. doi: 10.1016/j.brachy.2024.11.008. Epub 2025 Jan 9.
PMID: 39788791BACKGROUNDAmerican Brachytherapy Society - Ophthalmic Oncology Task Force. Electronic address: paulfinger@eyecancer.com; ABS - OOTF Committee. The American Brachytherapy Society consensus guidelines for plaque brachytherapy of uveal melanoma and retinoblastoma. Brachytherapy. 2014 Jan-Feb;13(1):1-14. doi: 10.1016/j.brachy.2013.11.008. Epub 2013 Dec 24.
PMID: 24373763BACKGROUNDAbouzeid H, Moeckli R, Gaillard MC, Beck-Popovic M, Pica A, Zografos L, Balmer A, Pampallona S, Munier FL. (106)Ruthenium brachytherapy for retinoblastoma. Int J Radiat Oncol Biol Phys. 2008 Jul 1;71(3):821-8. doi: 10.1016/j.ijrobp.2007.11.004. Epub 2008 Jan 22.
PMID: 18207660BACKGROUNDLucas JT, McGee R, Billups CA, Qaddoumi I, Merchant TE, Brennan RC, Wu J, Wilson MW. Prior non-irradiative focal therapies do not compromise the efficacy of delayed episcleral plaque brachytherapy in retinoblastoma. Br J Ophthalmol. 2018 Jun 28:bjophthalmol-2018-311923. doi: 10.1136/bjophthalmol-2018-311923. Online ahead of print.
PMID: 29954786BACKGROUNDMerchant TE, Gould CJ, Wilson MW, Hilton NE, Rodriguez-Galindo C, Haik BG. Episcleral plaque brachytherapy for retinoblastoma. Pediatr Blood Cancer. 2004 Aug;43(2):134-9. doi: 10.1002/pbc.20094.
PMID: 15236279BACKGROUNDMurakami N, Suzuki S, Ito Y, Yoshimura R, Inaba K, Kuroda Y, Morota M, Mayahara H, Sakudo M, Wakita A, Okamoto H, Sumi M, Kagami Y, Nakagawa K, Ohtomo K, Itami J. (1)(0)(6)Ruthenium plaque therapy (RPT) for retinoblastoma. Int J Radiat Oncol Biol Phys. 2012 Sep 1;84(1):59-65. doi: 10.1016/j.ijrobp.2011.11.002. Epub 2012 May 9.
PMID: 22575488BACKGROUNDSarici AM, Celkan TT, Oto BB, Sahin A, Uzel O, Ucar D. Episcleral Iodine-125 radioactive plaque brachytherapy as a salvage treatment for retinoblastoma in the era of intraarterial chemotherapy. Turk J Pediatr. 2022;64(2):285-292. doi: 10.24953/turkjped.2021.4217.
PMID: 35611417BACKGROUNDNegretti GS, Quhill H, Duncan C, Chowdhury T, Stoker I, Reddy MA, Sagoo MS. Ruthenium plaque radiotherapy in the current era of retinoblastoma treatment. Ophthalmic Genet. 2022 Dec;43(6):756-761. doi: 10.1080/13816810.2022.2141795. Epub 2022 Nov 1.
PMID: 36317817BACKGROUNDEchegaray JJ, Al-Zahrani YA, Singh A. Episcleral brachytherapy for retinoblastoma. Br J Ophthalmol. 2020 Feb;104(2):208-213. doi: 10.1136/bjophthalmol-2019-313985. Epub 2019 May 23.
PMID: 31122912BACKGROUNDAmendola BE, Markoe AM, Augsburger JJ, Karlsson UL, Giblin M, Shields JA, Brady LW, Woodleigh R. Analysis of treatment results in 36 children with retinoblastoma treated by scleral plaque irradiation. Int J Radiat Oncol Biol Phys. 1989 Jul;17(1):63-70. doi: 10.1016/0360-3016(89)90371-4.
PMID: 2745209BACKGROUNDGunduz K, Gunalp I, Yalcindag N, Unal E, Tacyildiz N, Erden E, Geyik PO. Causes of chemoreduction failure in retinoblastoma and analysis of associated factors leading to eventual treatment with external beam radiotherapy and enucleation. Ophthalmology. 2004 Oct;111(10):1917-24. doi: 10.1016/j.ophtha.2004.04.016.
PMID: 15465557BACKGROUNDNakamura S, Murakami N, Suzuki S, Ito K, Takemori M, Nakayama H, Kaga K, Chiba T, Iijima K, Takahashi K, Goka T, Itami J, Okamoto H, Igaki H. Monte Carlo simulation of tilted contact plaque brachytherapy placement for juxtapapillary retinoblastoma. Radiat Oncol. 2022 Jan 24;17(1):16. doi: 10.1186/s13014-022-01986-8.
PMID: 35073956BACKGROUNDSchueler AO, Fluhs D, Anastassiou G, Jurklies C, Neuhauser M, Schilling H, Bornfeld N, Sauerwein W. Beta-ray brachytherapy with 106Ru plaques for retinoblastoma. Int J Radiat Oncol Biol Phys. 2006 Jul 15;65(4):1212-21. doi: 10.1016/j.ijrobp.2006.02.002. Epub 2006 May 6.
PMID: 16682139BACKGROUNDShields CL, Shields JA, De Potter P, Minelli S, Hernandez C, Brady LW, Cater JR. Plaque radiotherapy in the management of retinoblastoma. Use as a primary and secondary treatment. Ophthalmology. 1993 Feb;100(2):216-24. doi: 10.1016/s0161-6420(93)31667-2.
PMID: 8437830BACKGROUNDShields JA, Giblin ME, Shields CL, Markoe AM, Karlsson U, Brady LW, Amendola BE, Woodleigh R. Episcleral plaque radiotherapy for retinoblastoma. Ophthalmology. 1989 Apr;96(4):530-7. doi: 10.1016/s0161-6420(89)32862-4.
PMID: 2726184BACKGROUND
MeSH Terms
Conditions
Interventions
Condition Hierarchy (Ancestors)
Intervention Hierarchy (Ancestors)
Study Officials
- STUDY DIRECTOR
Tamer Macky, PhD
Cairo University
- STUDY DIRECTOR
Abdussalam Abdussalam, PhD
Cairo University
Central Study Contacts
Study Design
- Study Type
- observational
- Observational Model
- COHORT
- Time Perspective
- RETROSPECTIVE
- Sponsor Type
- OTHER
- Responsible Party
- PRINCIPAL INVESTIGATOR
- PI Title
- Assistant Lecturer
Study Record Dates
First Submitted
April 3, 2026
First Posted
April 15, 2026
Study Start (Estimated)
May 1, 2026
Primary Completion (Estimated)
May 1, 2027
Study Completion (Estimated)
June 1, 2027
Last Updated
April 15, 2026
Record last verified: 2026-04