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. 2017 Jun 18;10(6):961-967.
doi: 10.18240/ijo.2017.06.20. eCollection 2017.

An international survey of classification and treatment choices for group D retinoblastoma

Christina Scelfo  1 , Jasmine H Francis  1   2 , Vikas Khetan  3 , Thomas Jenkins  4 , Brian Marr  1   2 , David H Abramson  1   2 , Carol L Shields  4 , Jacob Pe'er  5 , Francis Munier  6 , Jesse Berry  7 , J William Harbour  8 , Andrey Yarovoy  9 , Evandro Lucena  10 , Timothy G Murray  11 , Pooja Bhagia  12 , Evelyn Paysse  13 , Samuray Tuncer  14 , Guillermo L Chantada  15 , Annette C Moll  16 , Tatiana Ushakova  17 , David A Plager  18 , Islamov Ziyovuddin  19 , Carlos A Leal  20 , Miguel A Materin  21 , Xun-Da Ji  22 , Jose W Cursino  23 , Rodrigo Polania  24 , Hayyam Kiratli  25 , Charlotta All-Ericsson  26 , Rejin Kebudi  27 , Santosh G Honavar  28 , Vicktoria Vishnevskia-Dai  29 , Sidnel Epelman  30 , Anthony B Daniels  31 , Jeanie D Ling  31 , Fousseyni Traore  32 , Marco A Ramirez-Ortiz  33
Affiliations

An international survey of classification and treatment choices for group D retinoblastoma

Christina Scelfo et al. Int J Ophthalmol. .

Abstract

Aim: To determine which IIRC scheme was used by retinoblastoma centers worldwide and the percentage of D eyes treated primarily with enucleation versus globe salvaging therapies as well as to correlate trends in treatment choice to IIRC version used and geographic region.

Methods: An anonymized electronic survey was offered to 115 physicians at 39 retinoblastoma centers worldwide asking about IIRC classification schemes and treatment patterns used between 2008 and 2012. Participants were asked to record which version of the IIRC was used for classification, how many group D eyes were diagnosed, and how many eyes were treated with enucleation versus globe salvaging therapies. Averages of eyes per treatment modality were calculated and stratified by both IIRC version and geographic region. Statistical significance was determined by Chi-square, ANOVA and Kruskal-Wallis tests using Prism.

Results: The survey was completed by 29% of physicians invited to participate. Totally 1807 D eyes were diagnosed. Regarding IIRC system, 27% of centers used the Children's Hospital of Los Angeles (CHLA) version, 33% used the Children's Oncology Group (COG) version, 23% used the Philadelphia version, and 17% were unsure. The rate for primary enucleation varied between 0 and 100% and the mean was 29%. By IIRC version, primary enucleation rates were: Philadelphia, 8%; COG, 34%; and CHLA, 37%. By geographic region, primary enucleation rates were: Latin America, 57%; Asia, 40%; Europe, 36%; Africa, 10%, US, 8%; and Middle East, 8%. However, systemic chemoreduction was used more often than enucleation in all regions except Latin America with a mean of 57% per center (P<0.0001).

Conclusion: Worldwide there is no consensus on which IIRC version is used, systemic chemoreduction was the most frequently used initial treatment during the study period followed by enucleation and primary treatment modality, especially enucleation, varied greatly with regards to IIRC version used and geographic region.

Keywords: cancer; chemotherapy; enucleation; intra-arterial chemotherapy; oncology; ophthalmic artery chemosurgery; retina; retinoblastoma.

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Figures

Figure 1
Figure 1. Treatment choice by center for all eyes reported.
Figure 2
Figure 2. Comparison of treatment choice stratified by geographic region
AFR: Africa; EUR: Europe; ME: Middle East; LA: Latin America; IA: Intra-arterial.
See this image and copyright information in PMC

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