Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Aug;69(8):e29642.
doi: 10.1002/pbc.29642. Epub 2022 Apr 11.

Outcome of retinoblastoma treatment protocol in Cameroon as per SIOP-PODC recommendation for a low-income setting

Mariana Kruger  1 , Sabine L van Elsland  1 , Glenn M Afungchwi  1   2 , Richard Bardin  2 , Bernard Njodzeka  2 , Francine Kouya  2 , Patience Nfor  2 , Philippa Nana  2 , Paul Wharin  3 , Peter B Hesseling  1
Affiliations

Outcome of retinoblastoma treatment protocol in Cameroon as per SIOP-PODC recommendation for a low-income setting

Mariana Kruger et al. Pediatr Blood Cancer. 2022 Aug.

Abstract

Introduction: The International Society of Paediatric Oncology-Paediatric Oncology in Developing Countries (SIOP-PODC) group recommended graduated-intensity retinoblastoma treatment for children in low- and middle-income countries with limited local resources.

Aim: The aim was to improve outcome of children with retinoblastoma by means of a treatment protocol for low-income settings as recommended by the SIOP-PODC recommendation in Cameroon.

Methods: Children diagnosed with retinoblastoma between 2012 and 2016 were treated in two Baptist Mission hospitals in Cameroon, staging according to the International Retinoblastoma Staging System. Treatment included local therapy and combination chemotherapy (vincristine, cyclophosphamide, and doxorubicin) with or without surgery as per SIOP-PODC guidelines for low-income countries. Endpoint was survival at 24 months. Kaplan-Meier curves with log-rank (Mantel-Cox) chi-square (χ2 ) with respective p-values were prepared.

Results: Eighty-two children were included, of whom 79.3% had unilateral disease. The majority were males (61.0%) with median age 24 months (range 1-112 months; standard deviation [SD] 19). Limited disease was diagnosed in 58.5%, metastatic disease in 35.4%, and unknown stage in 6.1%. Overall survival (OS) was 50.0% at 24 months post diagnosis, but 68.8% for limited disease. Estimated cumulative survival at 24 months was 0.528 (standard error [SE] 0.056). Causes of death included disease progression/relapses (60.5%), neutropenic sepsis (15.9%), unknown causes (18.4%), unrelated infection (2.6%), and death post surgery (2.6%). Stage was significantly associated with OS (p < .001).

Conclusion: Stage was the most significant factor for good OS and demonstrated the efficacy and feasibility of the SIOP-PODC-proposed management guidelines for retinoblastoma in a lower middle-income setting.

Keywords: affordable treatment; low-income country; overall survival; retinoblastoma.

PubMed Disclaimer

References

REFERENCES

    1. Fabian ID, Abdallah E, Abdullahi SU, et al. Global retinoblastoma presentation and analysis by national income level. JAMA Oncol. 2020;6(5):685-695. https://doi.org/10.1001/jamaoncol.2019.6716
    1. Chantada GL. Retinoblastoma: lessons and challenges from developing countries. Ellsworth Lecture 2011. Ophthalmic Genet. 2011;32(4):196-203. https://doi.org/10.3109/13816810.2011.592173
    1. Chantada GL, Sampor C, Bosaleh A, Solernou V, Fandiño A, De Dávila MTG. Comparison of staging systems for extraocular retinoblastoma: analysis of 533 patients. JAMA Ophthalmol. 2013;131(9):1127-1134. https://doi.org/10.1001/jamaophthalmol.2013.260
    1. Kim JY, Park Y. Treatment of retinoblastoma: the role of external beam radiotherapy. Yonsei Med J. 2015;56(6):1478-1491. https://doi.org/10.3349/ymj.2015.56.6.1478
    1. Chantada G, Doz F, Antoneli CBG, et al. A proposal for an international retinoblastoma staging system. Pediatr Blood Cancer. 2006;47(6):801-805. https://doi.org/10.1002/pbc.20606

Publication types

LinkOut - more resources