Open AccessSurvival and outcome of retinoblastoma treated by neo‐adjuvant chemotherapy in India
Author(s) -
Gupta Sanjiv Kumar,
Meshram Madhuri,
Kumar Ajai,
Verma Nishant,
Agrawal Siddharth,
Kumar Archana
Publication year - 2019
Publication title -
cancer reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.261
H-Index - 5
ISSN - 2573-8348
DOI - 10.1002/cnr2.1137
Subject(s) - medicine , retinoblastoma , chemotherapy , radiation therapy , stage (stratigraphy) , malignancy , surgery , retrospective cohort study , pediatrics , mortality rate , survival rate , disease , biology , gene , paleontology , biochemistry , chemistry
Background Retinoblastoma is the most common intraocular malignancy during infancy and childhood. The survival rate for children with retinoblastoma has improved significantly in developed countries; however, the outcome of the disease in developing countries remains dismal. Neoadjuvant chemotherapy is useful in this clinical scenario and can improve the survival of these children in the developing and underdeveloped countries. Aim To study the outcome and related factors in retinoblastoma patients treated at a tertiary care hospital in northern India. Methods and Results A tertiary care center‐based retrospective study was done from the year 2009 to 2015. All patients underwent an examination under anesthesia and classified using International Classification of Retinoblastoma. All subjects received systemic chemotherapy and, additionally, local surgical therapy according to the stage of the disease. Extraocular presentation and/or residual/recurrent tumour was treated by radiotherapy. All the subjects who followed the treatment protocol were included in the study. Two hundred and forty‐seven eyes of 200 subjects were included after screening the records of 233 subjects, who presented with retinoblastoma from January 2009 until December 2015. Mortality rate was highest in Group E ( n = 50, 42.0%) followed by Group D ( n = 24, 33.8%), whereas there was no mortality in unilateral Group B and Group C. Total 126 (63.0%) patients were alive at the end of the study. Factors significantly associated with mortality were age at the time of diagnosis, latency in the diagnosis, and the stage of the disease at presentation. Conclusions Neo‐adjuvant chemotherapy shows promising results in terms of low recurrence rates. Latency in diagnosis, higher age at presentation, and advanced disease at presentation were associated with higher mortality. Subjects with early presentation had a favourable outcome, and cure was possible after completion of the therapy.