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.

Global retinoblastoma survival and globe preservation: a systematic review and meta-analysis of associations with socioeconomic and health-care factors

“…The pooled estimate in 2010-20 was 6% (0-20, I²=98%) for LICs, 34% (21-49, I²=99%) for LMICs, 47% (38-56, I²=96%) for UMICs, and 70% (60-80, I²=96%) for HICs (table 2; appendix p 8). Globally, the pooled estimate improved significantly, from 22% [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] in 1980-89 to 44% [36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52] in 2010-20 (p=0•017).…”

“…The globe salvage rates of advanced intraocular stage retinoblastoma were pooled and stratified by income level. Higher globe salvage rates for advanced intraocular disease were associated with higher income level, with UMICs improving from 31% in 2000-09 to 42% (33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51) in 2010-20 and HICs improving from 27% in 2000-09 to 57% (42-72; table 2) in 2010-20. Sparse data were available in LICs and a widening disparity is seen compared with LMICs.…”

Causes of death and survival analysis for patients with retinoblastoma in Jordan

“…In the low-income countries of Uganda, Senegal, and Nepal, survival rates are 60% ( 41 ), 53% ( 42 ), and 24% ( 43 ), respectively, with metastatic spread reported as the cause of most deaths in all three studies. Survival rates were much higher in developed countries; 99% in the United States ( 44 ), 100% in the United Kingdom ( 45 ), and 95% in Japan ( 46 ); most deaths resulted from trilateral Rb or second malignancies.…”

Molecular Biological Research on the Pathogenic Mechanism of Retinoblastoma

“…RB damages a patient’s sight, appearance, and mental health, and metastasis can even be life-threatening [ 2 ]. The survival rate of retinoblastoma in developed countries is over 95% [ 3 , 4 ]; however, in low-income countries, survival rates are significantly lower. In Uganda, the five-year survival rate is 60%, while in Senegal, it is 53% [ 5 , 6 ].…”