Published online August 1, 2006
PEDIATRICS Vol. 118 No. 2 August 2006, pp. e331-e336 (doi:10.1542/peds.2006-0226)
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ARTICLE

Socioeconomic Impact of Modern Multidisciplinary Management of Retinoblastoma

Matthew W. Wilson, MDa,b, Barrett G. Haik, MDa,b and Carlos Rodriguez-Galindo, MDc,d

a Departments of Ophthalmology
c Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee; Departments of Surgery
b Divisions of Ophthalmology
d Hematology/Oncology, St Jude Children’s Research Hospital, Memphis, Tennessee

OBJECTIVE. Our objective for this study was to examine the impact of the modern management of intraocular retinoblastoma on the patient and the family.

METHODS. This study comprises a retrospective, noncomparative case series of 25 consecutive patients with multifocal, intraocular retinoblastoma that was treated with primary systemic chemotherapy. Medical charts were reviewed, and the following data were extracted: patients’ age and gender, laterality of disease, and Reese-Ellsworth classification of each eye as well as the number of central venous lines placed, cycles of chemotherapy received, outpatient appointments, examinations under anesthesia, focal therapies administered, computed tomography/MRI, radiation treatments, anesthetic procedures administered, and miles traveled.

RESULTS. Twenty patients with bilateral and 5 with unilateral intraocular retinoblastoma (median age: 9.3 months) had 895 outpatient appointments and underwent 698 examinations under anesthesia with 230 focal therapies, 347 days of radiotherapy, 226 computed tomography scans/MRIs, and 38 central venous line placements. A total of 1272 anesthetic procedures (median: 50) were performed with no major complication. In all, patients traveled 822312 miles (median: 22214 miles) to receive their care. The median follow-up was 82 months.

CONCLUSIONS. Successful retinoblastoma management requires close surveillance, aggressive consolidation, and numerous anesthetic procedures, all of which the patients and the families must endure. There is a significant impact on the patient, the family, and hospital resources.

Key Words: retinoblastoma • chemotherapy • external beam radiotherapy

Abbreviations: EBRT—external beam radiotherapy • RE—Reese-Ellsworth • CT—computed tomography • BCVA—best corrected visual acuity

Accepted Feb 28, 2006.