Wen X, et al. Intravenous versus super-selected intra-arterial chemotherapy in children with advanced unilateral retinoblastoma: an open-label, multicentre, randomised trial. The Lancet. Child & adolescent health. 2023;7:613-620. PMID 37536351 ¶

One-paragraph summary¶

Six Chinese hospitals randomized 143 children with newly diagnosed unilateral group D/E disease to IAC or intravenous VEC.

Two-year progression-free globe salvage was 53% versus 27% (RR 1.97, 95% CI 1.27–3.07).
Myelosuppression was 51% versus 70%; IAC produced ophthalmic-artery occlusion in 3% and stenosis in 18%.

The open-label trial applies to selected unilateral advanced eyes without high-risk clinical factors; it does not settle bilateral care or long-term vision.

This is the pivotal route-comparison trial because it replaces cross-centre retrospective contrasts with randomized allocation.