Local treatment efficacy in different stages of retinoblastoma

Background. Nowadays local modalities play an important role in retinoblastoma (Rb) treatment. Despite a great number of publications in scientific literature about local treatment there are no scientific works about comparative analysis of treatment results depending on tumor stage.

Purpose of the study – to evaluate the efficacy of local ophtalmological modalities of Rb treatment in different tumor stages.

Materials and methods. The study includes 274 patients (357 eyes) with Rb treated from 2007 to 2022. The mean patients’ age at the time of treatment was 15 months (from 0 to 74 months), 58 % patients were male, 42 % – female. 193 (70 %) patients presented with binocular Rb, 81 (30 %) – with monocular. In 59 (22 %) patients local treatment was performed on the single eye. Tumors’ distribution by stages was as followed: T1a stage (group А) – 74 (21 %) eyes, T1b (group В) – 122 (34 %) eyes, T2a (group C) – 56 (15 %) eyes, T2b (group D) – 104 (29 %) eyes, T3 (group E) – 3 (1 %) eyes. As local methods thermotherapy, cryotherapy and brachytherapy were applied. The follow-up varied from 6 to 158 months (median – 49 months).

Results. Local treatment modalitites were analyzed by following criteria: local tumor control, complications, eye salvage, number of applied treatment modalities, mean regression period and survival (overall and disease-free). Results were analyzed overall and by comparative analysis on different tumor stages. Local tumor control was achieved in 93 % of cases (n = 328), in 7 % (n = 26) tumor relapse was observed. Local treatment complications were observed in 23 % of cases (n = 82). 329 eyes (93 %) were salvaged, 25 eyes (7 %) were enucleated. All of these criteria were significantly lower in eyes of patients with Rb of group D (p < 0.01). Comparative analysis in different stages showed that tumor stage significantly affected local tumor control (p = 0.0012), complications’ frequency (р = 0.001), eye salvage percentage (р < 0.0001) and doesn’t affect regression period (p = 0.3), number of treatment modalities (p = 0.3), overall (p = 0.74) and disease-free survival (p = 0.3).

Conclusion. Local methods showed high efficacy in Rb treatment. Initial tumor stage is relevant in the prognosis of the treatment efficacy. Treatment of patients with Rb of group D still remains to be challenging in aspects of local tumor control and eye salvage.

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