Effect of systemic chemotherapy on conditions of tumor infiltrating,metastasis and disease-specific survival for advanced retinoblastoma_Chinese Journal of Ocular Fundus Diseases

Authors：

LuLu ,  TangSong , GuoHui , LiuGuiqin , ZhaoDongsheng

Shenzhen Eye Hospital, Shenzhen Key Laboratory of Ophthalmology, Affiliated Shenzhen Eye Hospital of Jinan University, Shenzhen 518040, China;

Corresponding author：

TangSong, Email: ts0079@126.com

Keywords：

Retinoblastoma/drug therapy; Neoplasm metastasis/prevention & control; Chemotherapy,adjuvant

DOI：

10.3760/cma.j.issn.1005-1015.2016.04.014

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Objective To observe the effect of systemic chemotherapy on conditions of tumor infiltrating,metastasis and disease-specific survival (DSS) for advanced retinoblastoma (RB). Methods Forty-one patients with advanced RB who received enucleation were enrolled in this study. There were 26 males and 15 females, age at diagnosis was ranged from 2 to 72 months, with a mean of 23.08 months. There were 16 bilateral patients and 25 unilateral patients; 13 group D eyes and 28 group E eyes. 16 patients received enucleation as the primary treatment (operation group), 25 eyes received chemotherapy before enucleation (chemotherapy group). There was no significant statistical difference between two groups for the gender, unilateral and bilateral, international staging or diagnostic age (P>0.05). The histopathology report was performed to assess the risk of postoperative tumor-node-metastasis staging (pTNM) in each patient, and the extent of tumor invasion in the optic nerve, choroid and anterior chamber was divided into 3 levels of low risk, medium risk and high risk. Five deaths were all in the group E with chemotherapy before enucleation. Using R software survival analysis software package survfit function, the application of Kaplan-Meier estimation method, DSS of RB children was calculated from the time of diagnosis, up to the date of the death of patient. DSS differences between chemotherapy, operation group and eye removal time (more than 3 months, less than 3 months) in group E RB children were analyzed. Results The proportion of high risk pTNM stage in chemotherapy group was significantly lower than the operation group. But there was no significant difference between the two groups in the overall risk classification (χ²=3.130,P=0.077). For group D eyes, the overall risk classification in chemotherapy group was significantly lower than the operation group (χ²=5.870,P=0.015). There was no significant difference between the two groups in the overall risk of group E eyes (χ²=0.020,P=0.889). The DSS in chemotherapy group and operation group were 0.71 and 1.00, respectively; the difference was significant (χ²=3.700,P=0.05). The DSS in children whose enucleation delayed for more than 3 months and children whose enucleation performed within 3 months were 0.64 and 1.00, respectively; the difference was significant (χ²=4.800,P=0.028). Conclusion Systemic chemotherapy did not reduce the risk of tumor invasion and metastasis in patients with advanced RB. Instead, it will reduce the DSS in group E eyes of RB.

Citation： LuLu, TangSong, GuoHui, LiuGuiqin, ZhaoDongsheng. Effect of systemic chemotherapy on conditions of tumor infiltrating,metastasis and disease-specific survival for advanced retinoblastoma. Chinese Journal of Ocular Fundus Diseases, 2016, 32(4): 404-407. doi: 10.3760/cma.j.issn.1005-1015.2016.04.014 Copy

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1. Wilson MW, Rodriguez-Galindo C, Haik BG, et al. Multiagent chemotherapy as neoadjuvant treatment for multifocal intraocular retinoblastoma[J]. Ophthalmology, 2001,108(11):2106-2114. DOI:10.1016/S0161-6420(01)00805-3.
2. 赵军阳. 从R-E到IRC分级:视网膜母细胞瘤治疗观念的转变[J]. 眼科,2007,16(6):368-372. DOI:10.3969/j.issn.1004-4469.2007.06.004. Zhao JY. From R-E staging system to IRC system:the change of therapy for retinoblastoma[J].Ophthalmol CHN,2007,16(6):368-372. DOI:10.3969/j.issn.1004-4469.2007.06.004.
3. 唐松, 陆晓和,张国明,等.视网膜母细胞瘤综合治疗的临床分析[J].实用肿瘤杂志,2013,28(2):167-170.DOI:10.13267/j.cnki.syzlzz.2013.02.020. Tang S, Lu XH, Zhang GM,et al.The clinical analysis of combined therapy of retinoblastoma[J]. Journal of Practical Ocology, 2013,28(2):167-170. DOI:10.13267/j.cnki.Syzlzz.2013.02.020.
4. Finger PT, Harbour JW, Murphree AL. Retinoblastoma[M]//Edge SB, Byrd DR, Carducci MA. AJCC cancer staging manual. New York:Springer, 2010:561-568.
5. Kingston JE, Hungerford JL, Madreperla SA,et al. Results of combined chemotherapy and radiotherapy for advanced intraocular retinoblastoma[J]. Arch Ophthalmol,1996, 114(11):1339-1343.
6. Shields CL, Lally SE, Leahey AM,et al.Targeted retinoblastoma management:when to use intravenous, intra-arterial, periocular, and intravitreal chemotherapy[J]. Curr Opin Ophthalmol,2014,25(5):374-385. DOI:10.1097/ICU.0000000000000091.
7. Singh AD, Shields CL, Shields JA. Prognostic factors in retinoblastoma[J]. J Pediatr Ophthalmol Strabismus,2000,37(3):134-141.
8. Zhao J, Dimaras H, Massey C,et al. Pre-enucleation chemotherapy for eyes severely affected by retinoblastoma masks risk of tumor extension and increases death from metastasis[J].J Clin Oncol,2011, 29(7):845-851. DOI:10.1200/JCO.2010.32.5332.
9. Reese AB, Ellsworth RM.The evaluation and current concept of retinoblastoma therapy[J].Trans Am Acad Ophthalmol Otolaryngol,1963, 67:164-172.
10. Eng C, Li FP, Abramson DH, et al. Mortality from second tumors among long-term survivors of retinoblastoma[J].J Natl Cancer Inst,1993,85(14):1121-1128.

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Effect of systemic chemotherapy on conditions of tumor infiltrating,metastasis and disease-specific survival for advanced retinoblastoma

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