Outcomes of Intravenous Chemotherapy (Chemoreduction) for Retinoblastoma Based on Patient Age in 964 Eyes of 554 Patients
- PMID: 33481399
- DOI: 10.1097/APO.0000000000000360
Outcomes of Intravenous Chemotherapy (Chemoreduction) for Retinoblastoma Based on Patient Age in 964 Eyes of 554 Patients
Abstract
Purpose: To evaluate retinoblastoma control after intravenous chemotherapy (chemoreduction) by patient age at presentation.
Design: Retrospective case series.
Methods: This study included 964 eyes of 554 patients treated with chemoreduction at Ocular Oncology Service at Wills Eye Hospital. Patients received 6 monthly cycles of standard chemoreduction. Additional therapies for tumor control were performed as needed.
Results: Of 964 eyes, a comparison by age group (<6 months vs. 6-12 months vs. 13-24 months vs. >24 months) revealed more advanced age group with higher frequency of group E tumor (15% vs. 25% vs. 32% vs. 39%, P < 0.001). By treatment outcomes, complete tumor control was achieved with chemoreduction alone more often in less advanced age group (46% vs. 30% vs. 17% vs. 8%, P < 0.001). Additional treatment after chemoreduction was needed more often in more advanced age group with external beam radiotherapy (EBRT; 9% vs. 16% vs. 20% vs. 15%, P = 0.006) or enucleation (12% vs. 18% vs. 26% vs. 37%, P < 0.001). Over time (1994-1998 vs. 1999-2003 vs. 2004-2008 vs. 2009-2013 vs. 2014-2019), the paradigm for additional required treatment after chemoreduction shifted toward less EBRT (27% vs. 24% vs. 14% vs. 7% vs. 2%, P < 0.001) and more intra-arterial (0% vs. 0% vs. 1% vs. 25% vs. 48%, P < 0.001) and intravitreal (0% vs. 0% vs. 3% vs. 10% vs. 20%, P < 0.001) chemotherapy.
Conclusions: Chemoreduction is a safe and effective treatment method for patients with retinoblastoma, demonstrating the best tumor control in the younger age groups.
Copyright © 2021 Asia-Pacific Academy of Ophthalmology. Published by Wolters Kluwer Health, Inc. on behalf of the Asia-Pacific Academy of Ophthalmology.
Conflict of interest statement
The authors have no conflicts of interest to declare.
References
-
- Shields JA, Shields CL. Management and prognosis of retinoblastoma. In: Shields JA, ed. Intraocular Tumors: A Text and Atlas. Philadelphia, PA: WB Saunders; 1992:377–392.
-
- Shields CL, Shields JA. Diagnosis and management of retinoblastoma. Cancer Control 2004; 11:317–327.
-
- Abramson DH, Shields CL, Munier FL, Chantada GL. Treatment of retinoblastoma in 2015: agreement and disagreement. JAMA Ophthalmol 2015; 133:1341–1347.
-
- Shields CL, Meadows AT, Leahey AM, Shields JA. Continuing challenges in the management of retinoblastoma with chemotherapy. Retina 2004; 24:849–862.
-
- Shields CL, Shields JA. Editorial: chemotherapy for retinoblastoma. Med Pediatr Oncol 2002; 38:377–378.
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Other Literature Sources
