Author(s)

Boubacar Togo^1*, Fousseyni Traore¹, Konimba Diabaté², Fatou Sylla³, Aïchata Tall², Affiatou Simaga², Bakarou Kamaté⁴, Hawa Diall¹, Pierre Togo¹, Abdoul Karim Doumbia¹, Pierre Bey⁵, Francis Eshun⁶

¹Department of Pediatrics, Gabriel Toure Hospital, Bamako, Mali.
²Radiation Therapy Service, National Hospital of Mali, Bamako, Mali.
³Institute of Tropical Ophthalmology of Africa (IOTA), Bamako, Mali.
⁴Department of Histopathology, Hospital of Point G, Bamako, Mali.
⁵Curie Institute et AMCC, Paris, France.
⁶Phoenix Children’s Hospital, Phoenix, AZ, USA.

Retinoblastoma (RB) treatment aims at saving the life and preserving useful vision. In most low-income countries, because of delays in diagnosis, advanced disease presentation is quite common. This prospective study aimed at evaluating the treatment results of orbital RB with regards to overall survival rate of the patients treated with chemotherapy and radiotherapy. The study was performed from 01 November 2011 to 31 December 2015 in the paediatric oncology unit of Gabriel Touré Teaching Hospital, Bamako, Mali and The Institute of Tropical Ophthalmology of Africa (IOTA), Bamako, Mali. All intra-orbital non-metastatic RB cases not previously treated by chemotherapy or radiotherapy were included in this study. Fourteen patients were included into the study. Median age was 2 years, and sex ratio 2.5 (M = 10; F = 4). Right eye (n = 12, 85.7%) was more often affected than left eye (n = 2; 14.3%). Chemotherapy toxicities were mainly haematological including grade 3 anemia (n = 2; 7%) and grade 4 neutropenia (n = 3; 11%). Twelve patients (86%) were enucleated after neoadjuvant chemotherapy. Two patients (14%) abandoned treatment before enucleation. The IRSS pathology staging was: stage IIIa in 6 patients (50%), and stage II in six patients (50%). Six children (43%) received orbital radiotherapy at total dose of 45 Gy; Six children (43%) achieved complete remission; Overall survival rate was 48% at 4 years (95% CI: 22.5% - 74.4%). In conclusion, the therapeutic strategy based on neoadjuvant chemotherapy followed by enucleation, adjuvant chemotherapy and external beam radiotherapy, was beneficial in patients with stage III disease, achieving an event-free survival rate of 48%.

Orbital Retinoblastoma, Children, Mali

Togo, B. , Traore, F. , Diabaté, K. , Sylla, F. , Tall, A. , Simaga, A. , Kamaté, B. , Diall, H. , Togo, P. , Doumbia, A. , Bey, P. and Eshun, F. (2019) Results of Combined Chemotherapy and External Beam Radiotherapy for Unilateral Intra-Orbital Retinoblastoma—A Multi-Institutional Study from Mali. Open Journal of Pediatrics, 9, 39-46. doi: 10.4236/ojped.2019.91005.