Outcome of Retinoblastoma After Implementation of National Retinoblastoma Treatment Guidelines in South Africa.

IF 3.2 Q2 ONCOLOGY JCO Global Oncology Pub Date : 2024-08-01 DOI:10.1200/GO.24.00034
Mariana Kruger, Sabine L van Elsland, Alan Davidson, David Stones, Jan du Plessis, Gita Naidu, Jennifer Geel, Janet Poole, Judy Schoeman, Clare Stannard, Hamzah Mustak, Anel van Zyl, Julie Wetter, Karin Lecuona
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Abstract

Purpose: Retinoblastoma, a curable childhood cancer, has been identified as a tracer cancer in the WHO Global Initiative for Childhood Cancer. To document the outcomes of children with retinoblastoma in South Africa, treated as per the first prospective standard national treatment guidelines for childhood cancer in South Africa.

Patients and methods: All children diagnosed with retinoblastoma between 2012 and 2016 in five South African pediatric oncology units were treated with a standard treatment on the basis of the International Society of Pediatric Oncology-Pediatric Oncology in Developing Countries guidelines for high-income settings. Treatment included focal therapy with/without chemotherapy, or enucleation with/without chemotherapy, and orbital radiotherapy, depending on enucleated eye histology. The end point was survival at 24 months, using Kaplan-Meier curves with log-rank (Mantel-Cox) and chi-square (χ2) tests with respective P values reported.

Results: A total of 178 children were included in the study; 68% presented with unilateral disease. The median age was 27 months (range 0-118 months) with a male:female ratio of 1:0.75. The overall survival was 79% at 24 months with significant association with stage at diagnosis (P < .001) and older age over 2 years as opposed to younger than 2 years (P < .001). Causes of death were disease progression/relapses in 90% (34 of 38) and unknown in 2% (1 of 38), whereas treatment abandonment was 1.7% (3 of 178).

Conclusion: Efficacy with national treatment guidelines was confirmed, and feasibility of implementing standard national childhood cancer treatment guidelines was documented, involving multidisciplinary teams in South Africa. Outcome was significantly associated with stage at diagnosis and age.

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南非实施国家视网膜母细胞瘤治疗指南后的视网膜母细胞瘤治疗效果。
目的:视网膜母细胞瘤是一种可治愈的儿童癌症:视网膜母细胞瘤是一种可治愈的儿童癌症,已被世界卫生组织儿童癌症全球倡议确定为示踪癌症。目的:记录南非视网膜母细胞瘤患儿的治疗结果,这些患儿是根据南非首个儿童癌症前瞻性标准国家治疗指南接受治疗的:2012年至2016年期间,在南非五个儿科肿瘤科确诊为视网膜母细胞瘤的所有儿童均接受了根据国际儿科肿瘤学会-发展中国家儿科肿瘤指南为高收入环境制定的标准治疗方法。根据去核眼组织学情况,治疗方法包括病灶治疗(含/不含化疗)、去核治疗(含/不含化疗)和眼眶放疗。终点是24个月的存活率,采用Kaplan-Meier曲线和对数秩检验(Mantel-Cox)及秩和检验(χ2),并报告各自的P值:共有 178 名儿童参与研究,其中 68% 患有单侧疾病。中位年龄为 27 个月(0-118 个月),男女比例为 1:0.75。24个月时的总存活率为79%,与诊断时的分期(P < .001)和2岁以上而非2岁以下的年龄(P < .001)有显著相关性。死亡原因为疾病进展/复发的占90%(38例中的34例),不明原因的占2%(38例中的1例),而放弃治疗的占1.7%(178例中的3例):结论:国家治疗指南的疗效得到了证实,在南非多学科团队的参与下,实施标准的国家儿童癌症治疗指南的可行性也得到了证实。结果与诊断阶段和年龄有很大关系。
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来源期刊
JCO Global Oncology
JCO Global Oncology Medicine-Oncology
CiteScore
6.70
自引率
6.70%
发文量
310
审稿时长
7 weeks
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