The most devastating late adverse effect of childhood cancer treatment is development of second malignancies. Retinoblastoma is the most common ocular malignancy of childhood and has a very good cure rate. Children with hereditary retinoblastoma have an increased risk of developing second malignancies due to the genetic cancer predisposition status and the additional risk factors are exposure to chemotherapy (alkylating agents and topoisomerase II inhibitors) and external beam radiotherapy during treatment.
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