Risk Factors for Tumor Recurrence Following Primary Intravenous Chemotherapy (Chemoreduction) for Retinoblastoma in 869 Eyes of 551 Patients
| Autor: | Sameeksha Tadepalli, Sarangdev Vaidya, Zeynep Bas, Lauren A Dalvin, Raksha Rao, Carol L. Shields, Richard R Pacheco |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Retinal Neoplasms medicine.medical_treatment Enucleation Cryotherapy Carboplatin 03 medical and health sciences 0302 clinical medicine Risk Factors 030225 pediatrics Antineoplastic Combined Chemotherapy Protocols Humans Medicine External beam radiotherapy Fluorescein Angiography Child Infusions Intravenous Strabismus Etoposide Retrospective Studies Ultrasonography Chemotherapy business.industry Retinoblastoma Plaque radiotherapy Infant Newborn Infant Hyperthermia Induced General Medicine Odds ratio medicine.disease Combined Modality Therapy Surgery Ophthalmology Vincristine Child Preschool Pediatrics Perinatology and Child Health 030221 ophthalmology & optometry Female Neoplasm Recurrence Local business Tomography Optical Coherence |
| Zdroj: | Journal of Pediatric Ophthalmology & Strabismus. 57:224-234 |
| ISSN: | 1938-2405 0191-3913 |
| DOI: | 10.3928/01913913-20200417-01 |
| Popis: | Purpose: To identify risk factors for retinoblastoma recurrence following chemoreduction. Methods: This was a retrospective review of patients with retinoblastoma treated from 1994 to 2019 using chemoreduction with analysis for recurrence using Kaplan–Meier, Cox regression, and logistic regression. Results: There were 869 eyes of 551 patients with retinoblastoma treated with chemoreduction. Follow-up in 556 eyes revealed main solid tumor recurrence (n = 355, 64%), subretinal seed recurrence (n = 244, 44%), vitreous seed recurrence (n = 162, 29%), and/or new tumor (n = 118, 21%) requiring management with focal therapy (transpupillary thermotherapy, cryotherapy) (n = 294, 53%), intra-arterial chemotherapy (n = 125, 22%), intravitreal chemotherapy (n = 36, 6%), plaque radiotherapy (n = 120, 22%), external beam radiotherapy (n = 57, 10%), and/or enucleation (n = 49, 9%). Of all recurrences, 62% were detected by 1 year, 86% by 2 years, 94% by 3 years, 98% by 5 years, 99% by 10 years, and 100% by 15 years. Risk factors for recurrence on multivariate analysis included younger patient age at presentation (odds ratio [OR] = 1.02 [1.00 to 1.04] per 1 month decrease, P = .02), greater International Classification of Retinoblastoma group (OR = 1.24 [1.05 to 1.47] per 1 more advanced group, P = .01), shorter tumor distance to optic disc (OR = 1.11 [1.01 to 1.21] per 1 mm decrease, P = .03), and presence of subretinal seeds (OR = 1.66 [1.09 to 2.53], P = .02). Conclusions: Retinoblastoma recurrence after chemoreduction is usually detected within the first 3 years following treatment. Younger patients with more advanced, posteriorly located tumors and subretinal seeds at presentation are at increased risk, but recurrence can often be managed with globe-sparing therapy. [ J Pediatr Ophthalmol Strabismus . 2020;57(4):224–234.] |
| Databáze: | OpenAIRE |
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