Abstract
Purpose: :
To report the 12-year experience in the management of retinoblastoma and to determine the rate of the globe salvage and of enucleation in retinoblastoma patients.
Methods: :
A retrospective analysis of consecutive retinoblastoma cases diagnosed and treated at Bambino Gesu’ Hospital , Rome, between 1998 and 2010 was performed. We analyzed the patients as two groups: group 1 (65 eyes) diagnosed between 1998-2004, and group 2 (75 eyes) diagnosed between 2004-2010.
Results: :
A total of 140 eyes of 100 patients with unilateral (60 patients) and bilateral (40 patients) retinoblastoma were treated with enucleation, chemoreduction with consolidative therapy, external beam radiotherapy plus focal therapy including thermotherapy, criotherapy, laser photocoagulation or plaque radiotherapy. Patients were classified according to Reese-Ellsworth and the International Classification of Retinoblastoma . Fifty eyes (group 1) and 37 eyes (group 2) were treated with primary enucleation, 53 were treated conservatively. There were no bilateral enucleations. There were no deaths due to retinoblatoma. One child developed metastatic disease. The Kaplan- Meyer curves showed that 40% of patients group 1 and 63% group 2 avoid enucleation and external beam irradiation.
Conclusions: :
The introduction of conservative treatments have provide an alternative to traditional therapies such us enucleation and external beam radiotherapy. In our study we reported a decrease of enucleation rate, a stable mortality rate, and an improvement of ocular salvage in patients with unilateral and bilateral retinoblastoma.
Keywords: retinoblastoma • tumors • retinal detachment