An international survey of classification and treatment choices for group D retinoblastoma
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摘要
AIM: To determine which IIRC scheme was used by retinoblastoma centers worldwide and the percentage of D eyes treated primarily with enucleation versus globe salvaging therapies as well as to correlate trends in treatment choice to IIRC version used and geographic region.METHODS: An anonymized electronic survey was offered to 115 physicians at 39 retinoblastoma centers worldwide asking about IIRC classification schemes and treatment patterns used between 2008 and 2012. Participants were asked to record which version of the IIRC was used for classification, how many group D eyes were diagnosed, and how many eyes were treated with enucleation versus globe salvaging therapies. Averages of eyes per treatment modality were calculated and stratified by both IIRC version and geographic region. Statistical significance was determined by Chi-square, ANOVA and Kruskal-Wallis tests using Prism.RESULTS: The survey was completed by 29% of physicians invited to participate. Totally 1807 D eyes were diagnosed. Regarding IIRC system, 27% of centers used the Children's Hospital of Los Angeles(CHLA) version, 33% used the Children's Oncology Group(COG) version, 23% used the Philadelphia version, and 17% were unsure. The rate for primary enucleation varied between 0 and 100% and the mean was 29%. By IIRC version, primary enucleation rates were: Philadelphia, 8%; COG, 34%; and CHLA, 37%. By geographic region, primary enucleation rates were: Latin America, 57%; Asia, 40%; Europe, 36%; Africa, 10%, US, 8%; and Middle East, 8%. However, systemic chemoreduction was used more often than enucleation in all regions except Latin America with a mean of 57% per center(P<0.0001). CONCLUSION: Worldwide there is no consensus on which IIRC version is used, systemic chemoreduction was the most frequently used initial treatment during the study period followed by enucleation and primary treatment modality, especially enucleation, varied greatly with regards to IIRC version used and geographic region.
AIM: To determine which IIRC scheme was used by retinoblastoma centers worldwide and the percentage of D eyes treated primarily with enucleation versus globe salvaging therapies as well as to correlate trends in treatment choice to IIRC version used and geographic region.METHODS: An anonymized electronic survey was offered to 115 physicians at 39 retinoblastoma centers worldwide asking about IIRC classification schemes and treatment patterns used between 2008 and 2012. Participants were asked to record which version of the IIRC was used for classification, how many group D eyes were diagnosed, and how many eyes were treated with enucleation versus globe salvaging therapies. Averages of eyes per treatment modality were calculated and stratified by both IIRC version and geographic region. Statistical significance was determined by Chi-square, ANOVA and Kruskal-Wallis tests using Prism.RESULTS: The survey was completed by 29% of physicians invited to participate. Totally 1807 D eyes were diagnosed. Regarding IIRC system, 27% of centers used the Children's Hospital of Los Angeles(CHLA) version, 33% used the Children's Oncology Group(COG) version, 23% used the Philadelphia version, and 17% were unsure. The rate for primary enucleation varied between 0 and 100% and the mean was 29%. By IIRC version, primary enucleation rates were: Philadelphia, 8%; COG, 34%; and CHLA, 37%. By geographic region, primary enucleation rates were: Latin America, 57%; Asia, 40%; Europe, 36%; Africa, 10%, US, 8%; and Middle East, 8%. However, systemic chemoreduction was used more often than enucleation in all regions except Latin America with a mean of 57% per center(P<0.0001). CONCLUSION: Worldwide there is no consensus on which IIRC version is used, systemic chemoreduction was the most frequently used initial treatment during the study period followed by enucleation and primary treatment modality, especially enucleation, varied greatly with regards to IIRC version used and geographic region.
AIM: To determine which IIRC scheme was used by retinoblastoma centers worldwide and the percentage of D eyes treated primarily with enucleation versus globe salvaging therapies as well as to correlate trends in treatment choice to IIRC version used and geographic region.METHODS: An anonymized electronic survey was offered to 115 physicians at 39 retinoblastoma centers worldwide asking about IIRC classification schemes and treatment patterns used between 2008 and 2012. Participants were asked to record which version of the IIRC was used for classification, how many group D eyes were diagnosed, and how many eyes were treated with enucleation versus globe salvaging therapies. Averages of eyes per treatment modality were calculated and stratified by both IIRC version and geographic region. Statistical significance was determined by Chi-square, ANOVA and Kruskal-Wallis tests using Prism.RESULTS: The survey was completed by 29% of physicians invited to participate. Totally 1807 D eyes were diagnosed. Regarding IIRC system, 27% of centers used the Children's Hospital of Los Angeles(CHLA) version, 33% used the Children's Oncology Group(COG) version, 23% used the Philadelphia version, and 17% were unsure. The rate for primary enucleation varied between 0 and 100% and the mean was 29%. By IIRC version, primary enucleation rates were: Philadelphia, 8%; COG, 34%; and CHLA, 37%. By geographic region, primary enucleation rates were: Latin America, 57%; Asia, 40%; Europe, 36%; Africa, 10%, US, 8%; and Middle East, 8%. However, systemic chemoreduction was used more often than enucleation in all regions except Latin America with a mean of 57% per center(P<0.0001). CONCLUSION: Worldwide there is no consensus on which IIRC version is used, systemic chemoreduction was the most frequently used initial treatment during the study period followed by enucleation and primary treatment modality, especially enucleation, varied greatly with regards to IIRC version used and geographic region.
引文
1 Shields CL,Mashayekhi A,Au AK,Czyz C,Leahey A,Meadows AT,Shields JA.The International Classification of Retinoblastoma predicts chemoreduction success.Ophthalmology 2006;113(12):2276-2280.
2 Shields CL,Mashayekhi A,Demirci H,Meadows AT,Shields JA.Practical approach to management of retinoblastoma.Arch Ophthalmol2004;122(5):729-735.
3 Linn Murphree A.Intraocular retinoblastoma:the case for a new group classification.Ophthalmol Clin North Am 2005;18(1):41-53,viii.
4 Just Diagnosed:Staging.Children's Oncology Group Website.Available at https://www.childrensoncologygroup.org/index.php/newlydiagnosedwithretinoblastoma.September 2011.Accessed on March23,2016.
5 Waddell KM,Kagame K,Ndamira A,Twinamasiko A,Picton SV,Simmons IG,Johnston WT,Newton R.Clinical features and survival among children with retinoblastoma in Uganda.Br J Ophthalmol2015;99(3):387-390.
6 Lim FPM,Soh SY,Iyer JV,Tan AM,Swati H,Quah BL.Clinical profile,management,and outcome of retinoblastoma in Singapore.J Pediatr Ophthalmol Strabismus 2013;50(2):106-112.
7 Shah PK,Narendran V,Kalpana N.Outcomes of intra-and extraocular retinoblastomas from a single institute in South India.Ophthalmic Genet2015;36(3):248-250.
8 Naseripour M,Nazari H,Bakhtiari P,Modarres-zadeh M,Vosough P,Ausari M.Retinoblastoma in Iran:outcomes in terms of patients'survival and globe survival.Br J Ophthalmol 2009;93(1):28-32.
9 Huang D,Zhang Y,Zhang W,Wang Y,Zhang P,Hong L,Zhou Y,Han T,Zhi T.Study on clinical therapeutic effect including symptoms,eye preservation rate,and follow-up of 684 children with retinoblastoma.Eur J Ophthalmol 2013;23(4):532-538.
10 Cohen VM,Kingston J,Hungerford JL.The success of primary chemotherapy for group D heritable retinoblastoma.Br J Ophthalmol2009;93(7):887-890.
11 El Zomor H,Taha H,Aleieldin A,Nour R,Zaghloul MS,Fawzi M,Kamel A,Alfaar AS.High risk retinoblastoma:prevalence and success of treatment in developing countries.Ophthalmic Genet 2013;36(3):287-289.
12 Li SY,Chen SC,Tsai CF,Sheu SM,Yeh JJ,Tsai CB.Incidence and survival of retinoblastoma in Taiwan:a nationwide population-based study 1998-2011.Br J Ophthalmol 2016;100(6):839-842.
13 Hahn SM,Kim HS,Kim DJ,Lee SC,Lyu CJ,Han JW.Favorable outcome of alternate systemic and intra-arterial chemotherapy for retinoblastoma.Pediatr Hematol Oncol 2016;33(1):74-82.
14 Manjandavida FP,Honavar SG,Reddy VA,Khanna R.Management and outcome of retinoblastoma with vitreous seeds.Ophthalmology 2014;121(2):517-524.
15 Alkofide A,Ayas M,Khafagah Y,Rawashde A,Anas M,Barria M,Siddiqui K,Almesfer S,Alkatan H.Efficacy of vincristine and carboplatin as chemo-reduction for advanced bilateral retinoblastoma,the Saudi experience.Saudi J Ophthalmol 2013;27(3):193-196.
16 Okimoto S,Nomura K.Clinical manifestations and treatment of retinoblastoma in Kobe Children’s Hospital for 16 Years.J Pediatr Ophthalmol Strabismus 2014;51(4):222-229.
17 Akyüz C,Kiratli H,Sen H,Aydin B,Tarlan B,Varan A.Intraarterial chemotherapy for retinoblastoma:a single-center experience.Ophthalmologica 2015;234(4):227-232.
18 Bartuma K,Pal N,Kosek S,Holm S,All-Ericsson C.A 10-year experience of outcome in chemotherapy-treated hereditary retinoblastoma.Acta Ophthalmol 2013;92(5):404-411.
19 Kunkele A,Jurklies C,Wieland R,Lohmann D,Bornfeld N,Eggert A,Schulte JH.Chemoreduction improves eye retention in patients with retinoblastoma:a report from the German Retinoblastoma Reference Centre.Br J Ophthalmol 2013;97(10):1277-1283.
20 Palazzi MA,Stephan C,Brandalise SR,Aguiar Sdos S.Retinoblastoma diagnosis:a proposal based on the experience of Centro Infantil Boldrini,Brazil.Pediatr Hematol Oncol 2013;30(5):379-385.
21 Ossandón D,Zanolli M,Pérez V,Rojas T,Quijarro P,Kabalan P,Alvarez D,Varas M.Multidisciplinary management of retinoblastoma:Experience in 37 eyes.Arch Soc Esp Oftalmol 2015;90(2):55-62.
22 Shin JY,Kim JH,Yu YS,Khwarg SI,Choung HK,Shin HY,Ahn HS.Eyepreserving therapy in retinoblastoma:prolonged primary chemotherapy alone or combined with local therapy.Korean J Ophthalmol 2010;24(4):219-224.
23 El Kettani A,Aderdour S,Daghouj G,Knari S,Zaghloul K,Zafad S,Harif M,Benchekroun S.Retinoblastoma:preliminary results of national treatment protocol at Casablanca University Medical Center.J Fr Ophtalmol 2014;37(2):115-124.
24 Abramson DH,Daniels AB,Marr BP,Francis JH,Brodie SE,Dunkel IJ,Gobin YP.Intra-arterial chemotherapy(ophthalmic artery chemosurgery)for group D retinoblastoma.PLo S One 2016;11(1):e0146582.
25 Abramson DH,Fabius AW,Issa R,Francis JH,Marr BP,Dunkel IJ,Gobin YP.Advanced unilateral retinoblastoma:the impact of ophthalmic artery chemosurgery on enucleation rate and patient survival at MSKCC.PLo S One 2015;10(12):e0145436.
26 Abramson DH,Francis JH,Dunkel IJ,Marr BP,Brodie SE,Gobin YP.Ophthalmic artery chemosurgery for retinoblastoma prevents new intraocular tumors.Ophthalmology 2013;120(3):560-565.
27 Abramson DH,Marr BP,Dunkel IJ,Brodie S,Zabor EC,Driscoll SJ,Gobin YP.Intra-arterial chemotherapy for retinoblastoma in eyes with vitreous and/or subretinal seeding:2-year results.Br J Ophthalmol2012;96(4):499-502.
28 Abramson DH,Dunkel IJ,Brodie SE,Marr B,Gobin YP.Superselective ophthalmic artery chemotherapy as primary treatment for retinoblastoma(chemosurgery).Ophthalmology 2010;117(8):1623-1629.
29 Shields JA,Shields CL,Sivalingam V.Decreasing frequency of enucleation in patients with retinoblastoma.Am J Ophthalmol 1989;108(2):185-188.
30 Gündüz K,Günalp I,Yal??nda?N,Unal E,Ta?y?ld?z N,Erden E,Geyik P?.Causes of chemoreduction failure in retinoblastoma and analysis of associated factors leading to eventual treatment with external beam radiotherapy and enucleation.Ophthalmology 2004;111(10):1917-1924.
31 Grigorovski N,Lucena E,Mattosinho C,Parareda A,Ferman S,Catala J,Chantada G.Use of intra-arterial chemotherapy for retinoblastoma:results of a survey.Int J Ophthalmol 2014;7(4):726-730.
32 Shields CL,Kaliki S,Al-Dahmash S,Rojanaporn D,Leahey A,Griffin G,Jabbour P,Shields JA.Management of advanced retinoblastoma with intravenous chemotherapy then intra-arterial chemotherapy as alternative to enucleation.Retina 2013;33(10):2103-2109.
33 Berry JL,Jubran R,Kim JW,Wong K,Bababeygy SR,Almarzouki H,Lee TC,Murphree AL.Long-term outcomes of Group D eyes in bilateral retinoblastoma patients treated with chemoreduction and low-dose IMRT salvage.Pediatr Blood Cancer 2012;60(4):688-693.
2 Shields CL,Mashayekhi A,Demirci H,Meadows AT,Shields JA.Practical approach to management of retinoblastoma.Arch Ophthalmol2004;122(5):729-735.
3 Linn Murphree A.Intraocular retinoblastoma:the case for a new group classification.Ophthalmol Clin North Am 2005;18(1):41-53,viii.
4 Just Diagnosed:Staging.Children's Oncology Group Website.Available at https://www.childrensoncologygroup.org/index.php/newlydiagnosedwithretinoblastoma.September 2011.Accessed on March23,2016.
5 Waddell KM,Kagame K,Ndamira A,Twinamasiko A,Picton SV,Simmons IG,Johnston WT,Newton R.Clinical features and survival among children with retinoblastoma in Uganda.Br J Ophthalmol2015;99(3):387-390.
6 Lim FPM,Soh SY,Iyer JV,Tan AM,Swati H,Quah BL.Clinical profile,management,and outcome of retinoblastoma in Singapore.J Pediatr Ophthalmol Strabismus 2013;50(2):106-112.
7 Shah PK,Narendran V,Kalpana N.Outcomes of intra-and extraocular retinoblastomas from a single institute in South India.Ophthalmic Genet2015;36(3):248-250.
8 Naseripour M,Nazari H,Bakhtiari P,Modarres-zadeh M,Vosough P,Ausari M.Retinoblastoma in Iran:outcomes in terms of patients'survival and globe survival.Br J Ophthalmol 2009;93(1):28-32.
9 Huang D,Zhang Y,Zhang W,Wang Y,Zhang P,Hong L,Zhou Y,Han T,Zhi T.Study on clinical therapeutic effect including symptoms,eye preservation rate,and follow-up of 684 children with retinoblastoma.Eur J Ophthalmol 2013;23(4):532-538.
10 Cohen VM,Kingston J,Hungerford JL.The success of primary chemotherapy for group D heritable retinoblastoma.Br J Ophthalmol2009;93(7):887-890.
11 El Zomor H,Taha H,Aleieldin A,Nour R,Zaghloul MS,Fawzi M,Kamel A,Alfaar AS.High risk retinoblastoma:prevalence and success of treatment in developing countries.Ophthalmic Genet 2013;36(3):287-289.
12 Li SY,Chen SC,Tsai CF,Sheu SM,Yeh JJ,Tsai CB.Incidence and survival of retinoblastoma in Taiwan:a nationwide population-based study 1998-2011.Br J Ophthalmol 2016;100(6):839-842.
13 Hahn SM,Kim HS,Kim DJ,Lee SC,Lyu CJ,Han JW.Favorable outcome of alternate systemic and intra-arterial chemotherapy for retinoblastoma.Pediatr Hematol Oncol 2016;33(1):74-82.
14 Manjandavida FP,Honavar SG,Reddy VA,Khanna R.Management and outcome of retinoblastoma with vitreous seeds.Ophthalmology 2014;121(2):517-524.
15 Alkofide A,Ayas M,Khafagah Y,Rawashde A,Anas M,Barria M,Siddiqui K,Almesfer S,Alkatan H.Efficacy of vincristine and carboplatin as chemo-reduction for advanced bilateral retinoblastoma,the Saudi experience.Saudi J Ophthalmol 2013;27(3):193-196.
16 Okimoto S,Nomura K.Clinical manifestations and treatment of retinoblastoma in Kobe Children’s Hospital for 16 Years.J Pediatr Ophthalmol Strabismus 2014;51(4):222-229.
17 Akyüz C,Kiratli H,Sen H,Aydin B,Tarlan B,Varan A.Intraarterial chemotherapy for retinoblastoma:a single-center experience.Ophthalmologica 2015;234(4):227-232.
18 Bartuma K,Pal N,Kosek S,Holm S,All-Ericsson C.A 10-year experience of outcome in chemotherapy-treated hereditary retinoblastoma.Acta Ophthalmol 2013;92(5):404-411.
19 Kunkele A,Jurklies C,Wieland R,Lohmann D,Bornfeld N,Eggert A,Schulte JH.Chemoreduction improves eye retention in patients with retinoblastoma:a report from the German Retinoblastoma Reference Centre.Br J Ophthalmol 2013;97(10):1277-1283.
20 Palazzi MA,Stephan C,Brandalise SR,Aguiar Sdos S.Retinoblastoma diagnosis:a proposal based on the experience of Centro Infantil Boldrini,Brazil.Pediatr Hematol Oncol 2013;30(5):379-385.
21 Ossandón D,Zanolli M,Pérez V,Rojas T,Quijarro P,Kabalan P,Alvarez D,Varas M.Multidisciplinary management of retinoblastoma:Experience in 37 eyes.Arch Soc Esp Oftalmol 2015;90(2):55-62.
22 Shin JY,Kim JH,Yu YS,Khwarg SI,Choung HK,Shin HY,Ahn HS.Eyepreserving therapy in retinoblastoma:prolonged primary chemotherapy alone or combined with local therapy.Korean J Ophthalmol 2010;24(4):219-224.
23 El Kettani A,Aderdour S,Daghouj G,Knari S,Zaghloul K,Zafad S,Harif M,Benchekroun S.Retinoblastoma:preliminary results of national treatment protocol at Casablanca University Medical Center.J Fr Ophtalmol 2014;37(2):115-124.
24 Abramson DH,Daniels AB,Marr BP,Francis JH,Brodie SE,Dunkel IJ,Gobin YP.Intra-arterial chemotherapy(ophthalmic artery chemosurgery)for group D retinoblastoma.PLo S One 2016;11(1):e0146582.
25 Abramson DH,Fabius AW,Issa R,Francis JH,Marr BP,Dunkel IJ,Gobin YP.Advanced unilateral retinoblastoma:the impact of ophthalmic artery chemosurgery on enucleation rate and patient survival at MSKCC.PLo S One 2015;10(12):e0145436.
26 Abramson DH,Francis JH,Dunkel IJ,Marr BP,Brodie SE,Gobin YP.Ophthalmic artery chemosurgery for retinoblastoma prevents new intraocular tumors.Ophthalmology 2013;120(3):560-565.
27 Abramson DH,Marr BP,Dunkel IJ,Brodie S,Zabor EC,Driscoll SJ,Gobin YP.Intra-arterial chemotherapy for retinoblastoma in eyes with vitreous and/or subretinal seeding:2-year results.Br J Ophthalmol2012;96(4):499-502.
28 Abramson DH,Dunkel IJ,Brodie SE,Marr B,Gobin YP.Superselective ophthalmic artery chemotherapy as primary treatment for retinoblastoma(chemosurgery).Ophthalmology 2010;117(8):1623-1629.
29 Shields JA,Shields CL,Sivalingam V.Decreasing frequency of enucleation in patients with retinoblastoma.Am J Ophthalmol 1989;108(2):185-188.
30 Gündüz K,Günalp I,Yal??nda?N,Unal E,Ta?y?ld?z N,Erden E,Geyik P?.Causes of chemoreduction failure in retinoblastoma and analysis of associated factors leading to eventual treatment with external beam radiotherapy and enucleation.Ophthalmology 2004;111(10):1917-1924.
31 Grigorovski N,Lucena E,Mattosinho C,Parareda A,Ferman S,Catala J,Chantada G.Use of intra-arterial chemotherapy for retinoblastoma:results of a survey.Int J Ophthalmol 2014;7(4):726-730.
32 Shields CL,Kaliki S,Al-Dahmash S,Rojanaporn D,Leahey A,Griffin G,Jabbour P,Shields JA.Management of advanced retinoblastoma with intravenous chemotherapy then intra-arterial chemotherapy as alternative to enucleation.Retina 2013;33(10):2103-2109.
33 Berry JL,Jubran R,Kim JW,Wong K,Bababeygy SR,Almarzouki H,Lee TC,Murphree AL.Long-term outcomes of Group D eyes in bilateral retinoblastoma patients treated with chemoreduction and low-dose IMRT salvage.Pediatr Blood Cancer 2012;60(4):688-693.