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Socioeconomic impact of modern multidisciplinary management of retinoblastoma.

Wilson MW, Haik BG, Rodriguez-Galindo C

Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, Tennessee, USA. mwilson5@utmem.edu

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.

Published 2 August 2006 in Pediatrics, 118(2): e331-6.
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