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Published on: August 4, 2011
Outcome of interventional treatment modalities for retinoblastoma: Experience at a tertiary care centre in Pakistan
Lubna Siddiq Mian1, Amash Aqil1, Khadijah Abid2
1Lahore General Hospital.
Insights
Newer treatments like Ophthalmic artery chemosurgery (OAC) and Intravitreal Melphalan show promise for retinoblastoma, a common childhood eye cancer. These therapies can lead to tumor regression and vision preservation, even in advanced cases.
Area of Science:
- Ophthalmology
- Pediatric Oncology
- Medical Research
Background:
- Retinoblastoma is the most frequent intraocular cancer in infants.
- It significantly impacts child mortality and morbidity.
- Early detection and effective treatment are crucial for vision preservation.
Purpose of the Study:
- To evaluate the effectiveness of various treatment modalities for retinoblastoma.
- To assess the outcomes of newer treatments like Ophthalmic artery chemosurgery (OAC) and Intravitreal Melphalan.
- To analyze treatment success rates based on the International Classification of Retinoblastoma (ICRB) grading.
Main Methods:
- A case series study involving 19 children with retinoblastoma.
- Classification of retinoblastoma cases using the International Classification of Retinoblastoma (ICRB).
- Application of treatment modalities including chemo-reduction, OAC, Intravitreal Melphalan, cryotherapy, and laser photocoagulation.
- Follow-up period of 6 to 12 months to assess treatment outcomes.
Main Results:
- Tumor regression or obliteration was the primary outcome in most patients.
- Ophthalmic artery chemosurgery (OAC) and Intravitreal Melphalan demonstrated promising results in tumor regression.
- These newer modalities offered potential for vision salvage, even in higher ICRB grades.
- Treatment failures, including enucleation due to malignancy progression, were recorded.
Conclusions:
- Ophthalmic artery chemosurgery (OAC) and Intravitreal Melphalan are effective in achieving retinoblastoma tumor regression.
- These advanced treatments offer hope for vision salvation in retinoblastoma patients, including those with advanced disease.
- Treatment strategies should consider disease severity, patient factors, and available resources.
Abstract:
Retinoblastoma is the most common intra-ocular malignancy found in children in their infancy. Originating from the retinal cells, the disease has a significant association with mortality and morbidity. A case series study was conducted at the Lahore General Hospital eye department, from November 2016 to January 2018. Nineteen children having retinoblastoma in 19 eyes were included in the study. The retinoblastoma-affected eyes were classified according to the International Classification of Retinoblastoma (ICRB). Treatments assigned were based on the severity of the disease, monetary allowance and intervention availability. The treatment modalities employed were chemo-reduction, Ophthalmic artery chemosurgery (OAC), Intravitreal Melphalan, Cryotherapy and laser photocoagulation. To measure the outcome, the follow up period was between 6 to 12 months. The primary outcome measures among the majority of the patients were regres sion or obliteration of the tumour. Failure of treatments were also recorded which included progression of the malignancy requiring enucleation. This study concludes that the newer modalities such as OAC and Intravitreal Melphalan have shown promising results for tumour regression, leading to vision salvation, even at higher grades of ICRB.
