© 2004 by Oxford University Press
© 2004 Oxford University Press
EDITORIAL |
For Whom the Bell Tolls: Susceptibility to Common Adult Cancers in Retinoblastoma Survivors
Affiliations of authors: Genetics Branch, Center for Cancer Research, National Cancer Institute, and the National Naval Medical Center, Bethesda, MD (FJK); Ocular Oncology Service, Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, MO (JWH).
Correspondence to: Frederic J. Kaye, MD, Bldg. 8, Rm. 5101, National Naval Medical Center, 8901 Wisconsin Ave., Bethesda, MD 20889 (e-mail: fkaye@helix.nih.gov)
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A priority in the management of patients with potentially curable or indolent cancers is to maximize tumor control while minimizing the iatrogenic complications that may occur many years later. A balance between these short-term and long-term goals can sometimes be elusive, as seen in the ongoing controversy over the role of external beam radiation therapy (EBRT) in the initial treatment of patients with early-stage Hodgkin's disease (1). In the case of hereditary retinoblastoma, where more patients in the United States die of second primary cancers (many induced by EBRT) than from their initial eye tumor (2), the treatment for intraocular disease has recently undergone dramatic changes to minimize the delayed tumorigenic potential of EBRT. These changes focus on the substitution of EBRT with chemotherapy, followed by local consolidative modalities such as