Abstract
OBJECTIVE: To study the outcome of children with retinoblastoma treated
with primary chemotherapy.
METHODS: This was a hospital-based cohort prospective study of 91 children
with retinoblastoma out of which 27 children (32 eyes) fullled the inclusion
criteria. These children were admitted to Ophthalmology Unit, Lady Reading
st st Hospital, Peshawar, Pakistan during the period of 1 January 2011 to 31
December 2013. Diagnosis was established by compatible history and
ultrasonographic demonstration of posterior chamber mass with calcication.
CT-Scan aided in diagnosis and also excluded extra scleral/intracranial
extension. Examination under anesthesia allowed classifying the tumor
according to Reese-Ellsworth classication system. Children of consenting
parents were started on primary chemotherapy. Secondary treatment
consisted of cryotherapy and/or argon laser photocoagulation.
RESULTS: The mean age of the cohort was 2.35 years. A total of 72% had
advance stage IV or V disease. Secondary treatment was given in 43% eyes,
whereas, 57% needed to be enucleated. Chemoreduction salvaged 43% of
eyes. The mean survival in the cohort was 67.88 weeks and the Kaplan Meier
cumulative 2 year survival rate is 77%. Primary chemotherapy improved
survival in the cohort (none died). The test statistic (log rank is 20.04 (df-1);
2
p<0.001). But, was not attributed to preventing globe loss (x =2.52 (df-1),
p=0.112). Preventing globe loss was attributed to the stage of the disease at
2
time of diagnosis (x =11.476 (df-1), p<0.001).
CONCLUSION: Primary chemotherapy improves survival but not globe
salvage in children with retinoblastoma. Invariably, the deciding variable for
vision and globe salvage is the stage of disease at diagnosis.
Tariq Muhammad Saeed, Zafar Iqbal. (2019) OUTCOME OF CHILDREN WITH RETINOBLASTOMA TREATED WITH PRIMARY CHEMOTHERAPY, KHYBER MEDICAL UNIVERSITY JOURNAL, Volume 11, Issue 1.
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