Outcomes of neonatal retinoblastoma in pre-chemotherapy and chemotherapy eras

Purpose: To quantify outcomes for neonatal retinoblastoma patients treated during the pre-chemotherapy (1980-1994) and chemotherapy (1995-2018) eras. Methods: Retrospective review of retinoblastoma patients diagnosed within the first 28 days of life between 1/1/1980 and 11/30/2018. Student's t-...

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Bibliographic Details
Published in:Indian journal of ophthalmology 2019-12, Vol.67 (12), p.1997-2004
Main Authors: Camp, David, Dalvin, Lauren, Schwendeman, Rachel, Lim, Li-Anne, Shields, Carol
Format: Article
Language:English
Subjects:
Acuity
Age
Cancer
Cancer therapies
Chemotherapy
Clinical outcomes
Cryotherapy
Demographics
Enucleation
eye
Family medical history
intra-arterial
intravenous
Intravenous administration
intravitreal
Metastasis
neonatal
Neonates
Original
Patients
Radiation therapy
Retina
Retinoblastoma
Seeds
Thermotherapy
Tumors
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Summary:Purpose: To quantify outcomes for neonatal retinoblastoma patients treated during the pre-chemotherapy (1980-1994) and chemotherapy (1995-2018) eras. Methods: Retrospective review of retinoblastoma patients diagnosed within the first 28 days of life between 1/1/1980 and 11/30/2018. Student's t-test, Chi-square, and Fisher's exact test were performed to compare treatments and outcomes by era. Results: There were 68 patients with neonatal retinoblastoma (12% unilateral and 88% bilateral). According to era (pre-chemotherapy vs. chemotherapy), the number of treated patients was 26 (38%) vs. 42 (62%). Primary treatment was external beam radiotherapy (50% vs. 1%,P < 0.001), plaque radiotherapy (17% vs. 0%,P < 0.001), focal treatment (transpupillary thermotherapy or cryotherapy) only (21% vs. 14%,P= 0.33), intravenous chemotherapy (0% vs. 81%,P < 0.001), enucleation (10% vs. 4%,P= 0.26), or exenteration (2% vs. 0%,P= 0.37). Outcomes included tumor control (79% vs. 94%,P= 0.02), globe salvage (75% vs. 91%,P= 0.02), final gross visual acuity for salvaged eyes 20/200 or better (66% vs. 89%,P < 0.01), and death (19% vs. 0%,P < 0.01). Conclusion: Chemotherapy advancements for neonatal retinoblastoma have improved tumor control, globe salvage, visual acuity, and patient survival.
ISSN:0301-4738
1998-3689
DOI:10.4103/ijo.IJO_634_19