D Ossandón1, M Zanolli2, V Pérez3, T Rojas1, P Quijarro3, P Kabalan3, D Alvarez3, M Varas3. 1. Departamento de Oftalmología, Hospital San Juan de Dios, Santiago, Chile. 2. Departamento de Oftalmología, Hospital San Juan de Dios, Santiago, Chile. Electronic address: mario.zanolli@me.com. 3. Departamento de Oncología Pediátrica, Hospital San Juan de Dios, Santiago, Chile.
Abstract
OBJECTIVE: To report the results of the multidisciplinary management of patients with retinoblastoma, including survival, enucleation rate, and systemic chemoreduction success. METHODS: A retrospective study was conducted on 27 patients (37 eyes) diagnosed with retinoblastoma, and treated by a multidisciplinary team in San Juan de Dios Hospital. Demographic information, clinical characterization, survival, local and systemic treatments were included in the analysis. Patients treated with intra-arterial chemotherapy (IAC) were also reviewed. RESULTS: The study included14 male patients (52%). The median of age at presentation was 8 months (0.16-90). The median follow-up time was 33 ± 21 months. The diagnosis was made in 10 (37%) cases after 15 months old, with a median of 35 months (24-90). 17 (63%) patients had unilateral retinoblastoma, and 10 (37%) bilateral retinoblastoma. Leukocoria, isolated or associated with other signs, was the most frequent reason for referral (63%). Global enucleation rate was 57% (n=21), being the primary treatment in 15 (55%) patients. Enucleation rate in unilateral retinoblastoma was 76.5%, and for bilateral retinoblastoma, it was 60% for one eye and 10% for both. Systemic chemotherapy was prescribed in 17 (63%) patients, with a mean number of cycles of 5.3 ± 2.1. The overall success of chemoreduction and focal therapy in order to avoid external radiotherapy and/or enucleation was 68%. Three patients were treated with IAC as a salvage therapy, controlling the tumor in 2 patients at 6 months of follow-up. These are the first cases reported in Chile. Survival rate was 100%. CONCLUSION: Multidisciplinary management of retinoblastoma led to a survival rate and morbidity comparable with international reports.
OBJECTIVE: To report the results of the multidisciplinary management of patients with retinoblastoma, including survival, enucleation rate, and systemic chemoreduction success. METHODS: A retrospective study was conducted on 27 patients (37 eyes) diagnosed with retinoblastoma, and treated by a multidisciplinary team in San Juan de Dios Hospital. Demographic information, clinical characterization, survival, local and systemic treatments were included in the analysis. Patients treated with intra-arterial chemotherapy (IAC) were also reviewed. RESULTS: The study included14 male patients (52%). The median of age at presentation was 8 months (0.16-90). The median follow-up time was 33 ± 21 months. The diagnosis was made in 10 (37%) cases after 15 months old, with a median of 35 months (24-90). 17 (63%) patients had unilateral retinoblastoma, and 10 (37%) bilateral retinoblastoma. Leukocoria, isolated or associated with other signs, was the most frequent reason for referral (63%). Global enucleation rate was 57% (n=21), being the primary treatment in 15 (55%) patients. Enucleation rate in unilateral retinoblastoma was 76.5%, and for bilateral retinoblastoma, it was 60% for one eye and 10% for both. Systemic chemotherapy was prescribed in 17 (63%) patients, with a mean number of cycles of 5.3 ± 2.1. The overall success of chemoreduction and focal therapy in order to avoid external radiotherapy and/or enucleation was 68%. Three patients were treated with IAC as a salvage therapy, controlling the tumor in 2 patients at 6 months of follow-up. These are the first cases reported in Chile. Survival rate was 100%. CONCLUSION: Multidisciplinary management of retinoblastoma led to a survival rate and morbidity comparable with international reports.
Authors: Christina Scelfo; Jasmine H Francis; Vikas Khetan; Thomas Jenkins; Brian Marr; David H Abramson; Carol L Shields; Jacob Pe'er; Francis Munier; Jesse Berry; J William Harbour; Andrey Yarovoy; Evandro Lucena; Timothy G Murray; Pooja Bhagia; Evelyn Paysse; Samuray Tuncer; Guillermo L Chantada; Annette C Moll; Tatiana Ushakova; David A Plager; Islamov Ziyovuddin; Carlos A Leal; Miguel A Materin; Xun-Da Ji; Jose W Cursino; Rodrigo Polania; Hayyam Kiratli; Charlotta All-Ericsson; Rejin Kebudi; Santosh G Honavar; Vicktoria Vishnevskia-Dai; Sidnel Epelman; Anthony B Daniels; Jeanie D Ling; Fousseyni Traore; Marco A Ramirez-Ortiz Journal: Int J Ophthalmol Date: 2017-06-18 Impact factor: 1.779