Cause of death of children with intraocular retinoblastoma in the Beijing Children's Hospital 2009-2017_Chinese Journal of Ocular Fundus Diseases

Authors：

Zhang Shihan ¹ , Ma Xiaoli ¹ , Zhang Chengyue ² , Bai Dayong ² , Cui Yanhui ² , Su Yan ¹ , Zhang Dawei ¹ , Wang Xisi ¹ , Duan Chao ¹ , Zhao Junyang ² ,  Jin Mei ¹

1. Medical Oncology Department, Pediatric Oncology Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing Key Laboratory of Pediatric Hematology Ocology, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing 100045, China;
2. Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University, National Center for Children’s Health, Beijing 100045, China;

Corresponding author：

Jin Mei, Email: meijin1975@sina.com

Keywords：

Retinoblastoma; Cause of death; Antineoplastic combined chemotherapy protocols; Eye enucleation; Vitrectomy

DOI：

10.3760/cma.j.cn511434-20220131-00059

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Objective To observe and analyze the clinical characteristics of children who died of intraocular retinoblastoma (RB). Methods A retrospective clinical study. Fourteen children (23 eyes) with intraocular RB who died after receiving treatment in Beijing Children's Hospital from 2009 to 2017 were included in the study. Among the children, there were 7 males (10 eyes) and 7 females (13 eyes); 5 had unilateral and 9 had bilateral tumor. Age were 17.2±15.5 months. All children underwent RetCam examination. RB was staged according to the international intraocular RB classify. Among the 23 eyes, 1 eye was in stage B, 2 eyes were in stage C, 12 eyes in stage D, and 8 eyes in stage E. Treatment methods included a systemic (vincristine, etoposide and carboplatin) chemotherapy (VEC chemotherapy), enucleation surgery, and vitrectomy. The basic conditions including age, time of diagnosis, pathological diagnosis, treatment and main causes of death were retrospectively analyzed. Results Among the 14 cases, the first symptom was leukemia in 12 cases, red eye in 1 case, and squintin in 1 case. Systemic VEC chemotherapy was used for 1-6 courses of treatment; 5 cases were enucleated, 3 cases underwent histopathological examination; 3 cases were treated with vitrectomy. Among the 3 cases who underwent histopathological examination, the sclera and optic nerve, optic nerve and optic disc were invasted respectively. Seven patients died of tumor metastasis and/or intracranial lesions (50.0%, 7/14); the median survival time was 19 months. Four patients died of treatment (28.6%, 4/14), including 3 patients died of chemotherapy-related side effects, and 1 died of organ failure after enucleation surgery (7.1%); the median survival time was 3.5 months. Early abandonment of treatment died in 3 cases (21.4%, 3/14); the median survival time was 15 months. Conclusion Intracranial metastasis is the main cause of death in children with intraocular RB.

Citation： Zhang Shihan, Ma Xiaoli, Zhang Chengyue, Bai Dayong, Cui Yanhui, Su Yan, Zhang Dawei, Wang Xisi, Duan Chao, Zhao Junyang, Jin Mei. Cause of death of children with intraocular retinoblastoma in the Beijing Children's Hospital 2009-2017. Chinese Journal of Ocular Fundus Diseases, 2022, 38(3): 182-186. doi: 10.3760/cma.j.cn511434-20220131-00059 Copy

1.	Rodriguez-Galindo C, Wilson MW, Chantada G, et al. Retinoblastoma: one world, one vision[J/OL]. Pediatrics, 2008, 122(3): e763-e770[2008-09-01]. https://pubmed.ncbi.nlm.nih.gov/18762512/. DOI: 10.1542/peds.2008-0518.
2.	Jin M, Zhao J, Zhang D, et al. Analysis of the short-term curative effect of 356 cases of intraocular retinoblastoma in children[J]. Pediatr Investig, 2019, 2(4): 236-241. DOI: 10.1002/ped4.12095.
3.	MacCarthy A, Draper GJ, Steliarova-Foucher E, et al. Retinoblastoma incidence and survival in European children (1978-1997). Report from the automated childhood cancer information system project[J]. Eur J Cancer, 2006, 42(13): 2092-2102. DOI: 10.1016/j.ejca.2006.06.003.
4.	Canadian Retinoblastoma Society. National retinoblastoma strategy Canadian guidelines for care: stratégie thérapeutique du rétinoblastome guide clinique canadien[J]. Can J Ophthalmol, 2009, 44 Suppl 2: S1-88. DOI: 10.3129/i09-194.
5.	Linn Murphree A. Intraocular retinoblastoma: the case for a new group classification[J]. Ophthalmol Clin North Am, 2005, 18(1): 41-53. DOI: 10.1016/j.ohc.2004.11.003.
6.	马晓莉, 赵军阳, 金眉, 等. 北京儿童医院视网膜母细胞瘤3年诊断治疗效果总结[J]. 中华实用儿科临床杂志, 2014, 29(15): 1141-1144. DOI: 10.3760/j.issn.2095-428X.2014.15.006.Ma XL, Zhao JY, Jin M, et al. Treatment and short-term effect analysis of retinoblastoma in Beijing Children's Hospital for 3-year results[J]. Chin J Appl Clin Pediatr, 2014, 29(15): 1141-1144. DOI: 10.3760/j.issn.2095-428X.2014.15.006.
7.	Kaliki S. How to do an enucleation for retinoblastoma[J]. Community Eye Health, 2018, 31(101): 20-22.
8.	何小寒, 吴松一, 张国明, 等. 玻璃体手术治疗眼内晚期视网膜母细胞瘤临床研究[J]. 眼科新进展, 2014, 34(8): 764-765,768. DOI: 10.13389/j.cnki.rao.2014.0210.He XH, Wu SY, Zhang GM, et al. Vitreous surgery for advanced intraocular retinoblastoma[J]. Rec Adv Opthalmol, 2014, 34(8): 764-765,768. DOI: 10.13389/j.cnki.rao.2014.0210.
9.	Alkatan HM, Al Marek F, Elkhamary S. Demographics of pediatric orbital lesions: a tertiary eye center experience in Saudi Arabia[J]. J Epidemiol Glob Health, 2019, 9(1): 3-10. DOI: 10.2991/jegh.k.181224.001.
10.	Kletke SN, Feng ZX, Hazrati LN, et al. Clinical predictors at diagnosis of low-risk histopathology in unilateral advanced retinoblastoma[J]. Ophthalmology, 2019, 126(9): 1306-1314. DOI: 10.1016/j.ophtha.2019.04.003.
11.	Dimaras H, Kimani K, Dimba EA, et al. Retinoblastoma[J]. Lancet, 2012, 379(9824): 1436-1446. DOI: 10.1016/S0140-6736(11)61137-9.
12.	Rodrigues KE, Latorre Mdo R, de Camargo B. Atraso diagnóstico do retinoblastoma [Delayed diagnosis in retinoblastoma][J]. J Pediatr (Rio J), 2004, 80(6): 511-516. DOI: 10.2223/1266.
13.	Naseripour M, Nazari H, Bakhtiari P, et al. Retinoblastoma in Iran: outcomes in terms of patients' survival and globe survival[J]. Br J Ophthalmol, 2009, 93(1): 28-32. DOI: 10.1136/bjo.2008.139410.
14.	Sethi S, Pushker N, Kashyap S, et al. Extraocular retinoblastoma in Indian children: clinical, imaging and histopathological features[J]. Int J Ophthalmol, 2013, 6(4): 481-486. DOI: 10.3980/j.issn.2222-3959.2013.04.14.
15.	Bekibele CO, Ayede AI, Asaolu OO, et al. Retinoblastoma: the challenges of management in Ibadan, Nigeria[J]. J Pediatr Hematol Oncol, 2009, 31(8): 552-555. DOI: 10.1097/MPH.0b013e31819c5275.
16.	Jenkinson H. Retinoblastoma: diagnosis and management-the UK perspective[J]. Arch Dis Child, 2015, 100(11): 1070-1075. DOI: 10.1136/archdischild-2014-306208.
17.	Honavar SG, Singh AD, Shields CL, et al. Postenucleation adjuvant therapy in high-risk retinoblastoma[J]. Arch Ophthalmol, 2002, 120(7): 923-931. DOI: 10.1001/archopht.120.7.923.
18.	Shen T, Liu R, Lin J, et al. Pars plana vitrectomy and evisceration resulting in death due to misdiagnosis of retinoblastoma in children: a review of 3 cases[J/OL]. Medicine (Baltimore), 2015, 94(32): e1338[2015-08-14]. https://pubmed.ncbi.nlm.nih.gov/26266382/. DOI: 10.1097/MD.0000000000001338.
19.	Chantada GL, Fandiño AC, Guitter MR, et al. Results of a prospective study for the treatment of unilateral retinoblastoma[J]. Pediatr Blood Cancer, 2010, 55(1): 60-66. DOI: 10.1002/pbc.22503.
20.	Pant G, Verma N, Kumar A, et al. Outcome of extraocular retinoblastoma in a resource limited center from low middle income country[J]. Pediatr Hematol Oncol, 2017, 34(8): 419-424. DOI: 10.1080/08880018.2017.1422060.
21.	Gao J, Zeng J, Guo B, et al. Clinical presentation and treatment outcome of retinoblastoma in children of South Western China[J/OL]. Medicine (Baltimore), 2016, 95(42): e5204[2016-10-21]. https://pubmed.ncbi.nlm.nih.gov/27759657/. DOI: 10.1097/MD.0000000000005204.

1. Rodriguez-Galindo C, Wilson MW, Chantada G, et al. Retinoblastoma: one world, one vision[J/OL]. Pediatrics, 2008, 122(3): e763-e770[2008-09-01]. https://pubmed.ncbi.nlm.nih.gov/18762512/. DOI: 10.1542/peds.2008-0518.
2. Jin M, Zhao J, Zhang D, et al. Analysis of the short-term curative effect of 356 cases of intraocular retinoblastoma in children[J]. Pediatr Investig, 2019, 2(4): 236-241. DOI: 10.1002/ped4.12095.
3. MacCarthy A, Draper GJ, Steliarova-Foucher E, et al. Retinoblastoma incidence and survival in European children (1978-1997). Report from the automated childhood cancer information system project[J]. Eur J Cancer, 2006, 42(13): 2092-2102. DOI: 10.1016/j.ejca.2006.06.003.
4. Canadian Retinoblastoma Society. National retinoblastoma strategy Canadian guidelines for care: stratégie thérapeutique du rétinoblastome guide clinique canadien[J]. Can J Ophthalmol, 2009, 44 Suppl 2: S1-88. DOI: 10.3129/i09-194.
5. Linn Murphree A. Intraocular retinoblastoma: the case for a new group classification[J]. Ophthalmol Clin North Am, 2005, 18(1): 41-53. DOI: 10.1016/j.ohc.2004.11.003.
6. 马晓莉, 赵军阳, 金眉, 等. 北京儿童医院视网膜母细胞瘤3年诊断治疗效果总结[J]. 中华实用儿科临床杂志, 2014, 29(15): 1141-1144. DOI: 10.3760/j.issn.2095-428X.2014.15.006.Ma XL, Zhao JY, Jin M, et al. Treatment and short-term effect analysis of retinoblastoma in Beijing Children's Hospital for 3-year results[J]. Chin J Appl Clin Pediatr, 2014, 29(15): 1141-1144. DOI: 10.3760/j.issn.2095-428X.2014.15.006.
7. Kaliki S. How to do an enucleation for retinoblastoma[J]. Community Eye Health, 2018, 31(101): 20-22.
8. 何小寒, 吴松一, 张国明, 等. 玻璃体手术治疗眼内晚期视网膜母细胞瘤临床研究[J]. 眼科新进展, 2014, 34(8): 764-765,768. DOI: 10.13389/j.cnki.rao.2014.0210.He XH, Wu SY, Zhang GM, et al. Vitreous surgery for advanced intraocular retinoblastoma[J]. Rec Adv Opthalmol, 2014, 34(8): 764-765,768. DOI: 10.13389/j.cnki.rao.2014.0210.
9. Alkatan HM, Al Marek F, Elkhamary S. Demographics of pediatric orbital lesions: a tertiary eye center experience in Saudi Arabia[J]. J Epidemiol Glob Health, 2019, 9(1): 3-10. DOI: 10.2991/jegh.k.181224.001.
10. Kletke SN, Feng ZX, Hazrati LN, et al. Clinical predictors at diagnosis of low-risk histopathology in unilateral advanced retinoblastoma[J]. Ophthalmology, 2019, 126(9): 1306-1314. DOI: 10.1016/j.ophtha.2019.04.003.
11. Dimaras H, Kimani K, Dimba EA, et al. Retinoblastoma[J]. Lancet, 2012, 379(9824): 1436-1446. DOI: 10.1016/S0140-6736(11)61137-9.
12. Rodrigues KE, Latorre Mdo R, de Camargo B. Atraso diagnóstico do retinoblastoma [Delayed diagnosis in retinoblastoma][J]. J Pediatr (Rio J), 2004, 80(6): 511-516. DOI: 10.2223/1266.
13. Naseripour M, Nazari H, Bakhtiari P, et al. Retinoblastoma in Iran: outcomes in terms of patients' survival and globe survival[J]. Br J Ophthalmol, 2009, 93(1): 28-32. DOI: 10.1136/bjo.2008.139410.
14. Sethi S, Pushker N, Kashyap S, et al. Extraocular retinoblastoma in Indian children: clinical, imaging and histopathological features[J]. Int J Ophthalmol, 2013, 6(4): 481-486. DOI: 10.3980/j.issn.2222-3959.2013.04.14.
15. Bekibele CO, Ayede AI, Asaolu OO, et al. Retinoblastoma: the challenges of management in Ibadan, Nigeria[J]. J Pediatr Hematol Oncol, 2009, 31(8): 552-555. DOI: 10.1097/MPH.0b013e31819c5275.
16. Jenkinson H. Retinoblastoma: diagnosis and management-the UK perspective[J]. Arch Dis Child, 2015, 100(11): 1070-1075. DOI: 10.1136/archdischild-2014-306208.
17. Honavar SG, Singh AD, Shields CL, et al. Postenucleation adjuvant therapy in high-risk retinoblastoma[J]. Arch Ophthalmol, 2002, 120(7): 923-931. DOI: 10.1001/archopht.120.7.923.
18. Shen T, Liu R, Lin J, et al. Pars plana vitrectomy and evisceration resulting in death due to misdiagnosis of retinoblastoma in children: a review of 3 cases[J/OL]. Medicine (Baltimore), 2015, 94(32): e1338[2015-08-14]. https://pubmed.ncbi.nlm.nih.gov/26266382/. DOI: 10.1097/MD.0000000000001338.
19. Chantada GL, Fandiño AC, Guitter MR, et al. Results of a prospective study for the treatment of unilateral retinoblastoma[J]. Pediatr Blood Cancer, 2010, 55(1): 60-66. DOI: 10.1002/pbc.22503.
20. Pant G, Verma N, Kumar A, et al. Outcome of extraocular retinoblastoma in a resource limited center from low middle income country[J]. Pediatr Hematol Oncol, 2017, 34(8): 419-424. DOI: 10.1080/08880018.2017.1422060.
21. Gao J, Zeng J, Guo B, et al. Clinical presentation and treatment outcome of retinoblastoma in children of South Western China[J/OL]. Medicine (Baltimore), 2016, 95(42): e5204[2016-10-21]. https://pubmed.ncbi.nlm.nih.gov/27759657/. DOI: 10.1097/MD.0000000000005204.

Chinese Journal of Ocular Fundus Diseases

Cause of death of children with intraocular retinoblastoma in the Beijing Children's Hospital 2009-2017

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