Targeted chemotherapy in retinoblastoma: A step forward from patient survival to globe survival

Abstract

Background/ Objectives Despite being the most common intraocular malignancy in childhood, there is a substantial disparity between developing and developed countries in terms of patient and globe survival in retinoblastoma (Rb). The current study intends to determine patient and globe survival before and after the introduction of the new targeted treatment modalities in a developing country. Methods Medical records of 350 patients (516 eyes) with retinoblastoma referred to a tertiary referral center for Rb in Tehran, Iran, were reviewed. In order to compare patient and globe survival before and after the availability of the new treatment modalities, including intra-arterial and intravitreal chemotherapy, the patients were divided into group 1 (2001–2007) and group 2 (2008–2018) based on the calendar period of diagnosis. Results Two-hundred-twenty-three eyes of 149 patients and 293 eyes of 201 patients were categorized into groups 1 and 2, respectively. The 5-year patient survival was 97% across the current survey, and the overall survival rate was 96% in group 1 and 99% in group 2 (P = 0.08). Overall, 50% of eyes with retinoblastoma underwent enucleation, which was the primary in 63% (116/184) of the unilateral and 30% (99/322) of the bilateral cases. Primary enucleation was significantly lower in group 2 (35%) in contrast to group 1 (50%) (P < 0.001). In addition, globe survival improved significantly in the International Classification of Retinoblastoma Groups D (17% in group 1 vs. 66% in group 2, P < 0.001) and E (1% in group 1 vs. 23% in group 2 P < 0.001) during the two timelines. In enucleated eyes, despite the increased rate of prelaminar involvement in group 2 (13% vs. 2% in group 1, P = 0.003), the rate of high-risk histopathologic findings was similar between the two groups. Conclusion Similar to developed countries, the application of new targeted treatment modalities, including intra-arterial and intravitreal chemotherapy, has been associated with significantly improved globe survival in Rb patients. However, it should be noted that even with the availability of these novel treatment options, the decision for on-time enucleation should not be deferred.

Semi-Supervised Segmentation of Retinoblastoma Tumors in Fundus Images

“…While the Sørensen-Dice coefficient is a rich descriptor for results of image segmentation, studies such as [19] prefer to use simpler metrics. In [19], segmentation results have been compared with ground truth, using Sensitivity, Specificity and Accuracy metrics which are described in (7)(8)(9), respectively. The average value of each metric, regarding the evaluation data of this study, is presented in Table III.…”

“…Other signs include strabismus (misalignment of the eyes' visual axes), inflammation, pain, and redness of the affected eye [1]. Well-known treatments are enucleation, systemic chemotherapy, radiotherapy, and local therapies [7].…”

Lag time, high-risk histopathological features, metastasis, and survival interrelation in retinoblastoma: a perspective from lower-middle income country

“…Despite the development of cancer treatment modalities, these socioeconomic factors remain an immense challenge for cancer treatment in Indonesia, especially retinoblastoma. Interestingly, other study showed that the presentation of an advanced stage retinoblastoma has been decreased as a result of increased public and primary care provider awareness [57] . While preparing the more robust treatment for retinoblastoma (i.e., intraarterial chemotherapy or targeted therapy), the concept to raise retinoblastoma awareness among health care provider and parents is promising strategy to reduce the lag time of retinoblastoma presentation in lower-middle income country.…”

Spotlight on Targeted Chemotherapy in Retinoblastoma: Safety, Efficacy, and Patient Outcomes

“…25 Our experience showed similar outcomes; in the post-IAC era, the 17% and 1% globe survival rates in group D and E eyes were improved to 66% and 23%, respectively. 51 OncoTargets and Therapy 2022:15 https://doi.org/10.2147/OTT.S370878 DovePress 1547 Moreover, a 2021 meta-analysis has shown that the rate of globe survival for systemic chemotherapy alone is 93%, 83%, 73%, 40%, and 19% for group A-E eyes. 52 In comparison, the 1-year Kaplan-Meier estimate for ocular survival after IAC was 96% across different groups.…”

“… 25 Our experience showed similar outcomes; in the post-IAC era, the 17% and 1% globe survival rates in group D and E eyes were improved to 66% and 23%, respectively. 51 …”