Published online September 1, 2008
PEDIATRICS Vol. 122 No. 3 September 2008, pp. e763-e770 (doi:10.1542/10.1542/peds.2008-0518)

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SPECIAL ARTICLE

Retinoblastoma: One World, One Vision

Carlos Rodriguez-Galindo, MD^a,b, Mathew W. Wilson, MD^c, Guillermo Chantada, MD^d, Ligia Fu, MD^e, Ibrahim Qaddoumi, MD^f, Célia Antoneli, MD^g, Carlos Leal-Leal, MD^h, Tarun Sharma, MDⁱ, Margarita Barnoya, MD^j, Sidnei Epelman, MD^k, Louis Pizzarello, MD^l, Javier R. Kane, MD^a, Ray Barfield, MD, PhD^a, Thomas E. Merchant, DO, PhD^m, Leslie L. Robison, PhDⁿ, A. Linn Murphree, MD^o, Patricia Chevez-Barrios, MD^p, Michael A. Dyer, PhD^q, Joan O'Brien, MD^r, Raul C. Ribeiro, MD^a,b, John Hungerford, MD^s, Eugene M. Helveston, MD^t, Barrett G. Haik, MD^c and Judith Wilimas, MD^a,b

Departments of ^a Oncology
^m Radiological Sciences
ⁿ Epidemiology
^q Developmental Neurobiology
^b International Outreach Program, St Jude Children's Research Hospital, Memphis, Tennessee
^c Department of Ophthalmology and Hamilton Eye Institute, University of Tennessee Health Sciences Center, Memphis, Tennessee
^d Department of Oncology, Hospital Nacional de Pediatria J.P. Garrahan, Buenos Aires, Argentina
^e Department of Hematology-Oncology, Hospital de Niños, Tegucigalpa, Honduras
^f Department of Pediatrics, King Hussein Cancer Center, Amman, Jordan
^g Department of Pediatrics, Hospital do Câncer A.C. Camargo, São Paulo, Brazil
^h Department of Oncology, Instituto Nacional de Pediatria, Mexico City, Mexico
ⁱ Sankara Nethralaya Foundation, Chennai, India
^j Unidad Nacional de Oncologia Pediátrica, Guatemala City, Guatemala
^k International Network for Cancer Treatment and Research, São Paulo, Brazil
^l International Agency for the Prevention of Blindness and Mailman School of Public Health, Columbia University, New York, New York
^o Department of Ophthalmology, Childrens Hospital Los Angeles, Los Angeles, California
^p Department of Pathology, Texas Children's Cancer Center, Houston, Texas
^r Department of Ophthalmology, University of California, San Francisco, California
^s Department of Ophthalmology, St Bartholomew's Hospital, London, England
^t Orbis International and Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana

Retinoblastoma is curable when diagnosed early and treated appropriately; however, the prognosis is dismal when the basic elements of diagnosis and treatment are lacking. In developing countries, poor education, lower socioeconomic conditions, and inefficient health care systems result in delayed diagnosis and suboptimal care. Furthermore, the complexity of multidisciplinary care required is seldom possible. Whereas ocular salvage is a priority in the Western world, death from retinoblastoma is still a major problem in developing countries. To bring the 2 ends of this spectrum together and provide a forum for discussion, the "One World, One Vision" symposium was organized, at which clinicians and researchers from various cultural, geographic, and socioeconomic backgrounds converged to discuss their experiences. Strategies for early diagnosis in developing countries were discussed. Elements of the development of retinoblastoma centers in developing countries were discussed, and examples of successful programs were highlighted. An important component in this process is twinning between centers in developing countries and mentor institutions in high-income countries. Global initiatives by nongovernmental organizations such as the International Network for Cancer Treatment and Research, Orbis International, and the International Agency for Prevention of Blindness were presented. Treatment of retinoblastoma in developing countries remains a challenge; however, it is possible to coordinate efforts at multiple levels, including public administrations and nonprofit organizations, to improve the diagnosis and treatment of retinoblastoma and to improve the outcome for these children.

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Key Words: developing countries • retinoblastoma

Abbreviations: RtbMex—Grupo Mexicano de Retinoblastoma • INCTR—International Network for Cancer Treatment and Research

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Accepted May 6, 2008.

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