Extraocular retinoblastoma: A 13‐year experience

Antoneli, Célia Beatriz Gianotti; Steinhorst, Flávio; Ribeiro, Karina de Cássia Braga; Novaes, Priscila; Chojniak, Martha Motono; Arias, Victor; Camargo, Beatriz de

doi:10.1002/cncr.11647

Cited by 130 publications

(103 citation statements)

References 47 publications

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“…A subsequent study showed that 12 patients with positive optic nerve surgical margins were all event-free survivors following chemotherapy as above and orbital radiation therapy of 4,000 -4,500 cGy. A similar successful study was reported from Brazil [80].Patients with metastatic extraocular disease have a poor prognosis when treated with regimens of conventional doses of chemotherapy. There are several reports now suggesting that high-dose chemotherapy with stem cell rescue combined with EBR for areas of bulky disease at diagnosis is beneficial, with some long-term survivors among patients with metastatic disease not involving the central nervous system (CNS) [81][82][83][84][85].…”

supporting

confidence: 67%

Retinoblastoma: Review of Current Management

Chintagumpala

Chévez-Barrios

Paysse³

et al. 2007

The Oncologist

172

141

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After completing this course, the reader will be able to:1. Discuss the need for a multidisciplinary approach to the management of children with retinoblastoma.2. Identify the patient factors that need to be considered when choosing the most appropriate initial and subsequent treatment for a child with retinoblastoma.3. Describe the role of genetics in the follow-up of retinoblastoma patients.Access and take the CME test online and receive 1 AMA PRA Category 1 Credit ™ at CME.TheOncologist.com CME CME ABSTRACTThe most common ocular cancer in children is retinoblastoma. It affects approximately 300 children in the U.S. every year. It can affect one or both eyes and the disease can be inherited. Altered discoloration of the pupil and strabismus are the usual symptoms that lead to medical attention. Subsequent appropriate diagnostic studies and care provided by a multidisciplinary team, including an ophthalmologist, a pediatric oncologist, a radiation oncologist, and a geneticist, among others, often result in optimal short-term and long-term care. The best initial and subsequent treatments are based on whether the child has unilateral or bilateral disease, the stage of the disease, and the age of the child. Enucleation, chemotherapy, and various forms of radiation therapy along with local ophthalmic therapies can be used in the treatment of retinoblastoma. Cure rates are high in children when the tumor is confined to the eye and has not spread systemically or into the orbit or brain. Children with the heritable form of retinoblastoma are at high risk for developing subsequent malignancies, most commonly sarcomas. This risk is greater for those children with the heritable form of the disease who were exposed to ionizing radiation at age <1 year. Exciting discoveries using animal models are providing new insights into the development of this disease and opening new avenues for targeted therapies that may lead to high cure rates with minimal toxicities. EPIDEMIOLOGYRetinoblastoma is the most common malignant ocular tumor in childhood and affects approximately 1 in 18,000 children Ͻ5 years of age in the U.S. [1]. The incidence is higher in developing countries, and in some countries in Central and South America retinoblastoma is one of the most common solid tumor malignancies in children [2]. The reason for this higher incidence is not clear. Lower socioeconomic status and the presence of human papilloma virus sequences in the retinoblastoma tissue have been implicated [3]. A higher risk for diseases like retinoblastoma in children born through in vitro fertilization was described previously, but a recent large study does not support this association [4]. Approximately 80% of children with retinoblastoma are diagnosed before 3 years of age. The diagnosis of retinoblastoma in children 6 years or older is extremely rare. Children with bilateral retinoblastoma constitute about 20%-30%. Patients with bilateral disease usually present at a younger age (14 -16 months) than patients with unilateral disease (29 -30 months) [...

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supporting

confidence: 67%

Retinoblastoma: Review of Current Management

Chintagumpala

Chévez-Barrios

Paysse³

et al. 2007

The Oncologist

172

141

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“…Such cases are more frequent in developing countries, occurring in more than 50% of children in some MICs compared to developed countries where they usually occur in less than 20% of the enucleated eyes. Studies in many upper MICs have yielded encouraging results, with survival rates greater than 80% for patients with these conditions [23,45,46]. However, as opposed to other childhood malignancies, there are no randomized studies to support the treatment decisions in these cases.…”

Section: Treating Patients With High-risk Pathology Featuresmentioning

confidence: 99%

Strategies to manage retinoblastoma in developing countries

Chantada

Qaddoumi

Canturk³

et al. 2010

Pediatric Blood & Cancer

127

109

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Survival of retinoblastoma is >90% in developed countries but there are significant differences with developing countries in stage at presentation, available treatment options, family compliance, and survival. In low‐income countries (LICs), children present with advanced disease, and the reasons are socioeconomic and cultural. In middle‐income countries (MICs), survival rates are better (>70%), but there is a high prevalence of microscopically disseminated extraocular disease. Programs for eye preservation have been developed, but toxicity‐related mortality is higher. Although effective treatment of microscopically extraocular disease improved the outcome, worldwide survival will be increased only by earlier diagnosis and better treatment adherence. Pediatr Blood Cancer 2011;56:341–348. © 2010 Wiley‐Liss, Inc.

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“…5 In one study of chemotherapy, the patients had extraocular retinoblastoma. 130 The remaining studies were of patients with intraocular retinoblastoma or the type of retinoblastoma was not explicitly stated. Three studies explicitly stated that the participants had newly diagnosed retinoblastoma 130,131,133 and one study explicitly stated previous treatments that had been received.…”

Section: Participantsmentioning

confidence: 99%

“…130 The remaining studies were of patients with intraocular retinoblastoma or the type of retinoblastoma was not explicitly stated. Three studies explicitly stated that the participants had newly diagnosed retinoblastoma 130,131,133 and one study explicitly stated previous treatments that had been received. 38 However, the remaining studies were unclear as to whether patients had received previous treatments, although some specific previous treatments were excluded in individual studies.…”

Section: Participantsmentioning

confidence: 99%

“…38 However, the remaining studies were unclear as to whether patients had received previous treatments, although some specific previous treatments were excluded in individual studies. In the majority of studies, patients were treated in a single centre, 38,[108][109][110][111][112][113][114]116,118,120,124,127,128,[130][131][132][133][134] and in the remaining studies patients were from two or more centres or from a registry, patients treated in the UK, 106,116,124,126 in 18 studies they were treated in the USA, 5,38,107,[109][110][111][113][114][115]119,[121][122][123]128,129,131,133,134 in six they were treated in a European country other than the UK 108,112,117,120,125,127 and in...…”

Section: Participantsmentioning

confidence: 99%

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Systematic review of effectiveness of different treatments for childhood retinoblastoma

McDaid

Hartley²,

Bagnall³

et al. 2005

Health Technol Assess

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Extraocular retinoblastoma: A 13‐year experience

Cited by 130 publications

References 47 publications

Retinoblastoma: Review of Current Management

Retinoblastoma: Review of Current Management

Strategies to manage retinoblastoma in developing countries

Systematic review of effectiveness of different treatments for childhood retinoblastoma

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