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Diana A Tamboli, Arun D Singh, Alan Topham; Treatment Patterns and Survival of Patients with Retinoblastoma: A Surveillance, Epidemiology, and End Results Dataset Evaluation. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3086.
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© ARVO (1962-2015); The Authors (2016-present)
Treatment of Retinoblastoma (Rb) over the years has shifted from enucleation and radiation towards multimodal therapy involving chemotherapy and focal therapy. We sought to analyze the SEER database to determine the treatment patterns of Rb and its impact on survival from 1975 to 2010.
The SEER dataset was used to identify cases of Rb using ICD-03 histology codes. Special permission was granted by the SEER administration to release chemotherapy information for this study (information which is not available in the publically available SEER dataset). Treatment of Rb for patients with locoregional disease was characterized as surgical therapy, radiation therapy, chemotherapy or any form thereof across 4 time periods from 1975-2010. Overall survival was performed using the Kaplan-Meier method and compared using the log rank method.
There were 1452 cases of Rb identified from 1975-2010 with 48% of patients being male and 30% presenting with bilateral disease. Twelve hundred twenty (84%) patients presented with localized disease. Table 1 shows grouped treatment patterns over time with an increase in chemotherapy (+/- any treatment) from 16.5% to 50.2% and a decrease in surgery (+/- any treatment) from 96.2% to 88.5% and decrease in radiation from 15.2% to 4.9% from the 1975-1979 time period to the 2000-2010 time period. Ten year overall survival was approximately 97% for the two most contemporary time periods (1990-1999 and 2000-2010), 94% for 1975-1979 and 92% for 1980-1989.
Treatment trends for Rb show an increase in chemotherapy utilization with a decrease in surgery and radiation therapy from 1975-2010. Increased utilization of chemotherapy corresponds with an improvement in survival. Future studies with in depth analysis will be required to confirm treatment superiority of various forms of chemotherapy (intravenous, intra arterial, intravitreal).
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