July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Neonatal Retinoblastoma: Analysis of Treatment Outcomes in the Pre-Chemotherapy, Intravenous Chemotherapy, and Intra-arterial Chemotherapy Eras
Author Affiliations & Notes
  • David A Camp
    Ocular Oncology, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Lauren A Dalvin
    Ocular Oncology, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
    Ophthalmology, Mayo Clinic, Rochester, Minnesota, United States
  • Rachel Schwendeman
    Ocular Oncology, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Li-Anne S Lim
    Ocular Oncology, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Carol L. Shields
    Ocular Oncology, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Footnotes
    Commercial Relationships   David Camp, None; Lauren Dalvin, None; Rachel Schwendeman, None; Li-Anne Lim, None; Carol Shields, Eye Tumor Research Foundation (F)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 2332. doi:
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      David A Camp, Lauren A Dalvin, Rachel Schwendeman, Li-Anne S Lim, Carol L. Shields; Neonatal Retinoblastoma: Analysis of Treatment Outcomes in the Pre-Chemotherapy, Intravenous Chemotherapy, and Intra-arterial Chemotherapy Eras. Invest. Ophthalmol. Vis. Sci. 2019;60(9):2332.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Treatment of retinoblastoma during the neonatal period has evolved in recent decades. We performed a retrospective analysis to quantify outcome measures during three time periods: pre-intravenous chemotherapy (pre-IVC) (1980–1993), intravenous chemotherapy (IVC) (1994–2007), and intra-arterial chemotherapy (IAC) (2008–2018).

Methods : Patients diagnosed with retinoblastoma within the first 28 days of life examined at a single ocular oncology center from May 2, 1980 to June 29, 2018 were included. Records were reviewed for demographics, clinical features, treatment methods, and outcomes. ANOVA, Chi-square, and Fisher’s exact tests were performed to compare treatment features and outcomes (pre-IVC vs. IVC vs. IAC).

Results : There were 68 patients with neonatal retinoblastoma, 32 (47%) males and 36 (53%) females. Mean patient age was 14 days (median 13, range 1-28 days). Ocular involvement was unilateral in 9 (13%) and bilateral in 59 (87%) patients. According to era (pre-IVC vs. IVC vs. IAC), the number of treated patients was 26 (38%) vs. 31 (46%) vs. 11 (16%), and the primary treatment was external beam radiotherapy (24 (50%) vs. 1 (2%) vs. 0 (0%)), plaque radiotherapy (7 (15%) vs. 0 (0%) vs. 0 (0%)), laser/cryotherapy alone (10 (21%) vs. 12 (21%) vs. 0 (0%)), IVC (1 (2%) vs. 41 (72%) vs. 22 (100%)), IAC (0 (0%) vs. 0 (0%) vs. 0 (0%)), enucleation (5 (10%) vs. 3 (5%) vs. 0 (0%)), or exenteration (1 (2%) vs. 0 (0%) vs. 0 (0%)) (p<0.001). Outcomes included tumor control without enucleation (38 (79%) vs. 52 (91%) vs. 22 (100%), p=0.029), globe salvage (36 (75%) vs. 51 (89%) vs. 21 (95%), p=0.046), final visual acuity for salvaged eyes of 20/200 or better (21 (66%) vs. 42 (88%) vs. 19 (90%), p=0.035), and death (5 (19%) vs. 0 (0%) vs. 0 (0%), p=0.013). Secondary IAC (0 (0%) vs. 0 (0%) vs. 2 (9%), p=0.029) likely contributed to more favorable results in the IAC era.

Conclusions : Advances in chemotherapy for neonatal retinoblastoma have improved tumor control, with improved globe salvage, visual acuity, and survival from the pre-IVC era to the current IAC era.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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