I. Overview: Retinoblastoma (RB) is the most common primary malignant tumor of the eye in children, with a high degree of malignancy that can endanger the vision, eye and even the life of patients. Retinoblastoma is an embryonal tumor with early onset, with more than 89% of patients developing the disease before the age of 3 years and some children developing the disease at birth. Retinoblastoma can affect one or both eyes, with 30-40% of cases occurring in both eyes. Retinoblastoma is responsible for 6% of childhood blindness. Some patients with retinoblastoma are hereditary, and about 6% have a family history. Each year, more than 2000 new patients with retinoblastoma are diagnosed in China, and the cumulative number of patients is in the tens of thousands nationwide, with an increasing trend year by year. Although retinoblastoma is highly malignant, grows rapidly, metastasizes quickly, and metastases within the eye frame, intracranial and systemic metastases occur rapidly without timely treatment, retinoblastoma responds well to treatment, and is sensitive to chemotherapy and radiotherapy. Early detection and early treatment can cure more than 95% of retinoblastoma patients. Second, clinical symptoms of retinoblastoma: early stage is painless growth, so it is difficult to detect. The main manifestation is white pupil syndrome, that is, yellowish-white reflection can be seen through the pupil of the child at night, commonly known as cat’s eye. Further increase in tumor size increases the contents of the eye and raises the intraocular pressure, producing glaucoma symptoms, i.e. eye pain, headache, crying and restlessness in the child, observation of dilated pupils and cloudy corneas in the child. Some children with retinoblastoma may exhibit strabismus, low vision, chorioretinitis, etc. Some children with retinoblastoma may be found unintentionally during physical examination. When the tumor grows further, it may metastasize along the optic nerve into the skull, causing vomiting and other symptoms, and it may also metastasize along the choroid into the frame, or grow outward and protrude into the eye, or metastasize to distant places such as bone and bone marrow through lymphatic vessels and blood vessels. Clinically, retinoblastoma is generally divided into: intraocular stage, glaucoma stage, extraocular stage and metastatic stage. The intraocular stage can be further divided into 5 different risk levels according to the size of the tumor, how much it is, where it grows, and whether there are vitreous and crystal implants, in order to guide the treatment. Treatment of retinoblastoma: In the past, retinoblastoma was diagnosed with eye removal, and some children were treated with external radiotherapy. Since eye removal (especially 40% of children with double eyes) causes blindness and disability, and radiotherapy and eye removal both affect the facial development of children, resulting in a second surgery for cosmetic surgery when they grow up, which greatly affects the quality of survival, and the above methods have limited efficacy for advanced giant retinoblastoma and tumors with metastasis, the treatment of retinoblastoma is now internationally advocates the preservation of the eye as much as possible while saving life and, at the same time, preserving useful vision as much as possible. To this end, a comprehensive treatment strategy based on systemic systemic chemotherapy and local treatment is proposed. (i) Chemotherapy: It is a combination of multiple drugs given to patients with retinoblastoma by intravenous infusion, and is administered regularly for several days per course for several consecutive courses. Chemotherapeutic drugs can make the tumor shrink rapidly and play the effect of reducing the volume. Moreover, through intravenous administration, the drugs can reach all parts of the body and can kill metastatic lesions. (ii) Local treatment: Chemotherapy can shrink the huge tumor, but it is difficult to completely destroy the residual lesions. Local treatment of tumor through eye radioactive particle dressing, laser photocoagulation, freezing and heat therapy can further destroy residual tumor tissues and finally achieve cure. (iii) Interventional treatment: Due to the huge tumor and serious infiltration of surrounding tissues in patients with advanced retinoblastoma, and the existence of blood-eye barrier in human body, the dose of chemotherapeutic drugs reaching the local tumor of the eye is limited. In recent years, the interventional treatment of injecting chemotherapeutic drugs into the tumor locally through femoral artery cannulation has been developed, which is a good supplement to systemic chemotherapy. Interventional infusion of chemotherapeutic drugs into the artery can make the concentration of drugs reaching tumor tissues 10 to 30 times higher than that of general peripheral intravenous administration, which can play an effective role in controlling retinoblastoma and reducing systemic toxic side effects. The chemotherapeutic drugs injected through the artery can also enter the body circulation again, which can have certain effects on the clinical or subclinical metastases in the whole body, and at the same time, the drugs can flow into the tumor lesions again through the body circulation to play the role of secondary chemotherapy. Thus, it can achieve the purpose of better treatment of tumor. (4) Intrathecal injection of drugs: Due to the existence of blood-brain barrier in human body, when the tumor metastasizes to intracranial area, the chemotherapeutic drugs of systemic chemotherapy have limited access to brain tissue, which can be injected intrathecally through lumbar puncture, and the chemotherapeutic drugs can reach brain tissue through cerebrospinal fluid circulation to achieve the purpose of effective control of intracranial metastatic lesions. (v) Stem cell transplantation: For patients with advanced multiple metastases, they can also be treated with autologous stem cell transplantation after high-dose strong chemotherapy by clearing the marrow, thus effectively improving the efficacy of patients with advanced retinoblastoma. The use of the above tools can significantly improve the prognosis of patients with advanced disease, allowing most children with retinoblastoma to be cured, and preserving the eye and improving the quality of survival of children with retinoblastoma later in life.