The Burden of Treatment for Sporadic Unilateral Retinoblastoma in Australia

The objective of this study was to compare the burden of treatment of different primary treatment modalities for unilateral sporadic retinoblastoma.

Sixty individuals with unilateral sporadic retinoblastoma were treated at the Royal Children's Hospital Melbourne, Australia, between January 2000 and December 2022. All International Classification of Retinoblastoma (ICRB) staging groups were included for analysis. The total number of anaesthetics and the total number of other hospital visits were calculated. The data was stratified by primary treatment modality and time from diagnosis (less than 12 months vs. beyond 12 months). The minimum follow-up period was 12 months from diagnosis.

Average age at presentation was 24.85 ± 16.47 months. Forty children (66.7%) presented with ICRB Group E disease, 15 (25%) with Group D, 4 (6.7%) with Group C and 1 (1.6%) with Group B Disease. Forty-six (76.7%) children underwent primary enucleation, 9 (15%) underwent primary intravenous chemotherapy (IVC) and 5 (8.3%) were treated with intra-arterial chemotherapy (IAC). In the first 12 months following diagnosis, all measures of treatment burden were higher in children who underwent chemotherapy (intravenous or intra-arterial) compared to enucleation, except the number of ophthalmology outpatient appointments. Beyond 12 months of diagnosis, all measures of treatment burden were higher in children who underwent chemotherapy compared to enucleation alone, except the total number of anaesthetics and the number of day admissions. There were no deaths.

Globe-conserving therapies, such as primary IVC and IAC, are associated with a significantly higher burden of treatment compared to primary enucleation in the management of unilateral sporadic retinoblastoma.