TITLE:
Results of Combined Chemotherapy and External Beam Radiotherapy for Unilateral Intra-Orbital Retinoblastoma—A Multi-Institutional Study from Mali
AUTHORS:
Boubacar Togo, Fousseyni Traore, Konimba Diabaté, Fatou Sylla, Aïchata Tall, Affiatou Simaga, Bakarou Kamaté, Hawa Diall, Pierre Togo, Abdoul Karim Doumbia, Pierre Bey, Francis Eshun
KEYWORDS:
Orbital Retinoblastoma, Children, Mali
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.9 No.1,
January
29,
2019
ABSTRACT: 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%.