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Huang Y, Guo Y. Quality of life among people with eye cancer: a systematic review from 2012 to 2022. Health Qual Life Outcomes 2024; 22:3. [PMID: 38185647 PMCID: PMC10773080 DOI: 10.1186/s12955-023-02219-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 12/11/2023] [Indexed: 01/09/2024] Open
Abstract
BACKGROUND Eye cancer is a serious eye disease that threatens patients' lives. In the past decade, there have been more and more studies on eye cancer. From the recently published eye cancer literature review, it can be seen that the two most popular research hotspots are retinoblastoma (RB) and uveal melanoma (UM) [1, 2]. Although several studies have assessed QOL in different types of eye cancer patients, a study that synthesizes the factors influencing QOL in eye cancer patients is yet to be undertaken. This study aimed to review and evaluate the literature related to the QOL of RB and UM survivors, and provide a synthesis of the current evidence on the impact of the two types of eye cancer on the overall QOL of patients. METHODS Eight databases (APA Psych Articles, CINAHL Complete, Health Source: Nursing/Academic Edition, MEDLINE Complete, Scopus, Cochrane Library, PubMed, and Registers (Clinicaltrials.gov.)) were searched between January 2012 and December 2022 for English, peer-reviewed quantitative original studies within this review. All publications were screened using the Preferred Reporting Items for Systematic Review and Meta-Analyses reporting guidelines. The methodological quality of the reviews was assessed using the Joanna Briggs Institute Critical Appraisal Checklists. The findings were summarised and tabulated accordingly. RESULTS Seventeen articles were analysed. Among them, 14 articles on patients with UM, and three articles on patients with RB using 18 different types of measurement tools were included. Eight researchers claimed that the overall QOL of patients with eye cancer was better than or similar to that of the general healthy population. However, nine studies indicated that these patients had poorer QOL than others. Many factors affect QOL, including treatment, sex, and age. CONCLUSION This systematic review identified the QOL levels and several factors that influence the QOL of ocular cancer patients worldwide, due to the variability in quality of the studies, it also showed the need for further research to assess factors affecting long-term QOL outcomes in RB and UM survivors. Simultaneously, it clarified the necessity and importance of developing standardized and complete assessment tools to compare QOL in different countries. Early interventions can be developed to improve the survivors' QOL by identifying potential deficits in specific areas.
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Affiliation(s)
- Yonghui Huang
- Henan Provincial People's Hospital, Henan Provincial Eye Hospital, Henan Provincial Key Medicine Laboratory of Nursing, Zhengzhou University People's Hospital, Henan University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, 450003, Henan, China.
| | - Yunfei Guo
- Henan Provincial People's Hospital, Henan Provincial Eye Hospital, Henan Provincial Key Medicine Laboratory of Nursing, Zhengzhou University People's Hospital, Henan University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, 450003, Henan, China
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Belson PJ, Pike NA, Eastwood JA, Brecht ML, Berry JL, Hays RD. Vision-related quality of life compared to generic measures in retinoblastoma survivors. Qual Life Res 2023; 32:1095-1105. [PMID: 36520266 PMCID: PMC9753081 DOI: 10.1007/s11136-022-03315-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE To (1) Compare vision-related quality of life (VRQOL) in adolescent and young adult (AYA) unilateral versus bilateral retinoblastoma (RB) survivors using a vision-targeted measure and a generic health-related quality of life (HRQOL) measure and (2) Assess associations among VRQOL and generic HRQOL domains and overall QOL and estimate associations of the VRQOL and HRQOL domains with overall QOL. METHODS The National Institute for Health (NIH) Toolbox® VRQOL instrument, PROMIS®-29 Profile v 2.1, and a single-item QOL measure were administered in a cross-sectional study of 101 RB survivors. Reliability for multi-item scales was estimated. Product-moment and Spearman rank correlation coefficients and stepwise ordinary least squares were used to measure associations of other variables with overall QOL. RESULTS Significantly worse VRQOL was reported by bilateral than unilateral RB survivors. Cronbach's alpha coefficients for all VRQOL scales ranged from 0.83 to 0.95. Medium to large correlations were found between all NIH Toolbox® VRQOL scales and the PROMIS®-29 measures. Depression and ability to participate in social roles and activities from the PROMIS®-29 Profile accounted for 38% of the variance in overall QOL with the psychosocial domain of the NIH Toolbox® VRQOL explaining 16% of the variance. CONCLUSION VRQOL is impaired in bilateral RB survivors. VRQOL is associated substantially with the PROMIS-29 generic HRQOL measure but has significant unique associations with overall QOL. The NIH Toolbox® VRQOL measure provides important information about the vision-related effects on daily life of AYA RB survivors.
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Affiliation(s)
- Paula J. Belson
- Department of Anesthesiology and Critical Care Medicine, Children’s Hospital Los Angeles, 4650 Sunset Blvd. Mailstop #12, CA 90027 Los Angeles, USA
| | - Nancy A. Pike
- Department of Anesthesiology and Critical Care Medicine, Children’s Hospital Los Angeles, 4650 Sunset Blvd. Mailstop #12, CA 90027 Los Angeles, USA
- School of Nursing, University of California, Los Angeles, CA USA
| | - Jo-Ann Eastwood
- School of Nursing, University of California, Los Angeles, CA USA
| | - Mary-Lynn Brecht
- School of Nursing, University of California, Los Angeles, CA USA
| | - Jesse L. Berry
- Department of Anesthesiology and Critical Care Medicine, Children’s Hospital Los Angeles, 4650 Sunset Blvd. Mailstop #12, CA 90027 Los Angeles, USA
- USC Roski Eye Institute, University of Southern California Keck School of Medicine, Los Angeles, CA USA
| | - Ron D. Hays
- RAND Corporation, Santa Monica, CA USA
- School of Medicine, School of Public Health, University of California. Los Angeles, Los Angeles, USA
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Belson PJ, Eastwood JA, Brecht ML, Kim JW, Hays RD, Pike NA. Health-Related Quality of Life in Adolescent and Young Adult Retinoblastoma Survivors. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2022; 39:342-357. [PMID: 35674414 PMCID: PMC9807776 DOI: 10.1177/27527530221073766] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Background: Retinoblastoma (RB) is a malignant intraocular tumor diagnosed in early childhood that requires extensive medical and surgical treatment at a young age. Health-related quality of life (HRQOL) is thought to be diminished due to visual impairment, facial deformities, and fear of recurrence or secondary cancer. However, few studies have identified variables associated with HRQOL among those with RB. Purpose: To compare HRQOL of adolescents and young adults (AYAs) with RB to matched controls and to identify predictors of HRQOL in RB survivors. Methods: Using a cross-sectional design, 198 AYAs (101 RBs and 97 controls) completed HRQOL (PROMIS®-29 profile) and psychosocial questionnaires (Rosenberg self-esteem scale, multidimensional scale of perceived social support, and Hollingshead index for socioeconomic status). Clinical variables (age at diagnosis, visual acuity, laterality, heredity, treatment regime, and anesthesia exposure) were extracted from the medical record. Correlates of HRQOL were estimated using linear regression models. Results: RB survivors reported similar HRQOL compared to controls. Physical function (p < .001), social support (p = .013), and self-esteem (p = .028) were lower in the RB group compared to controls. Visual acuity and self-esteem accounted for 52% of the variance in PROMIS physical health summary scores and self-esteem accounted for 38% of the variance in mental health summary scores. Conclusion: Despite deficits in physical function and self-esteem HRQOL in RB survivors was comparable to healthy counterparts. However, the majority of RB survivors in this study had normal visual acuity. Clinicians should explore ways to enhance self-esteem in RB survivors.
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Affiliation(s)
| | | | | | - Jonathan W. Kim
- Children’s Hospital, Los Angeles, CA, USA
- USC Roski Eye Institute, University of Southern California, Los
Angeles, CA, USA
| | - Ron D. Hays
- University of California, Los Angeles, CA, USA
- RAND Corporation, Santa Monica, CA, USA
| | - Nancy A. Pike
- Children’s Hospital, Los Angeles, CA, USA
- University of California, Los Angeles, CA, USA
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Association between Subjective and Objective Assessment of Enucleation Outcome Depending on the Presence of an Orbital Implant in Patients with Uveal Melanoma. J Clin Med 2022; 11:jcm11082141. [PMID: 35456233 PMCID: PMC9024917 DOI: 10.3390/jcm11082141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 03/26/2022] [Accepted: 04/07/2022] [Indexed: 11/17/2022] Open
Abstract
We aimed to assess the cosmetic outcome of patients who underwent enucleation for uveal melanoma. The subjective assessment was based on a questionnaire, including four questions on postoperative cosmetic outcome. As part of the objective assessment, the following features were evaluated using a four-point scale: the symmetry of the upper eyelid sulcus, color matching between the prosthetic and healthy eye, prosthetic eye motility, and eyelid position. We enrolled 90 patients after enucleation (58 with and 32 without an orbital implant). The overall subjective assessment scores were 3.5/4 and 3.3/4 points in patients with and without an implant, respectively. The overall objective assessment scores were 3.3/4 and 2.3/4 in patients with and without an implant, respectively (p < 0.001). The cosmetic outcome was rated significantly higher by patients than by investigators (p < 0.05). There was no significant association between the overall subjective and objective assessment of the cosmetic outcome in any of the groups. Cosmetic outcome after enucleation for uveal melanoma was highly rated by patients. It was rated higher by patients than by investigators. The presence of an orbital implant was associated with higher objective assessment scores in terms of the symmetry of the upper lid sulcus, prosthetic eye motility, and eyelid position.
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Reschke M, Biewald E, Bronstein L, Brecht IB, Dittner-Moormann S, Driever F, Ebinger M, Fleischhack G, Grabow D, Geismar D, Göricke S, Guberina M, Le Guin CHD, Kiefer T, Kratz CP, Metz K, Müller B, Ryl T, Schlamann M, Schlüter S, Schönberger S, Schulte JH, Sirin S, Süsskind D, Timmermann B, Ting S, Wackernagel W, Wieland R, Zenker M, Zeschnigk M, Reinhardt D, Eggert A, Ritter-Sovinz P, Lohmann DR, Bornfeld N, Bechrakis N, Ketteler P. Eye Tumors in Childhood as First Sign of Tumor Predisposition Syndromes: Insights from an Observational Study Conducted in Germany and Austria. Cancers (Basel) 2021; 13:cancers13081876. [PMID: 33919815 PMCID: PMC8070790 DOI: 10.3390/cancers13081876] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 04/05/2021] [Accepted: 04/09/2021] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Eye tumors in children are very rare. In Europe, these eye tumors are nearly always diagnosed early and cure rates are high. However, eye tumors in childhood often occur as the first sign of a genetic tumor predisposition syndrome. This study collected data of children with malignant eye tumors diagnosed in five years in Germany and Austria to learn about the association of eye tumors in childhood with tumor predisposition syndrome. The study recruited 300 children with malignant eye tumors in childhood. In the here-presented cohort, more than 40% of eye tumors were associated with rare tumor predisposition syndromes. For this reason, all children with eye tumors and their families should receive genetic counseling for a tumor predisposition syndrome. Children with a genetic predisposition to cancer should receive a tailored surveillance, including detailed history, physical examination and, if indicated, imaging to screen for other cancers later in life. Abstract Retinoblastoma and other eye tumors in childhood are rare diseases. Many eye tumors are the first signs of a genetic tumor predisposition syndrome and the affected children carry a higher risk of developing other cancers later in life. Clinical and genetic data of all children with eye tumors diagnosed between 2013–2018 in Germany and Austria were collected in a multicenter prospective observational study. In five years, 300 children were recruited into the study: 287 with retinoblastoma, 7 uveal melanoma, 3 ciliary body medulloepithelioma, 2 retinal astrocytoma, 1 meningioma of the optic nerve extending into the eye. Heritable retinoblastoma was diagnosed in 44% of children with retinoblastoma. One child with meningioma of the optic nerve extending into the eye was diagnosed with neurofibromatosis 2. No pathogenic constitutional variant in DICER1 was detected in a child with medulloepithelioma while two children did not receive genetic analysis. Because of the known association with tumor predisposition syndromes, genetic counseling should be offered to all children with eye tumors. Children with a genetic predisposition to cancer should receive a tailored surveillance including detailed history, physical examinations and, if indicated, imaging to screen for other cancer. Early detection of cancers may reduce mortality.
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Affiliation(s)
- Madlen Reschke
- Department of Pediatric Hematology and Oncology, Charité-Universitätsmedizin, 13353 Berlin, Germany; (M.R.); (J.H.S.); (A.E.)
| | - Eva Biewald
- Department of Ophthalmology, University Hospital Essen, University Duisburg Essen, 45122 Essen, Germany; (E.B.); (C.H.D.L.G.); (T.K.); (S.S.); (N.B.); (N.B.)
| | - Leo Bronstein
- Institute of Biostatistics and Clinical Research, University of Muenster, 48149 Münster, Germany;
| | - Ines B. Brecht
- Department of Pediatric Hematology and Oncology, Children’s University Hospital Tübingen, 72076 Tübingen, Germany; (I.B.B.); (M.E.)
| | - Sabine Dittner-Moormann
- Department of Pediatric Hematology and Oncology, University Hospital Essen, University Duisburg Essen, 45122 Essen, Germany; (S.D.-M.); (G.F.); (T.R.); (S.S.); (R.W.); (D.R.)
| | - Frank Driever
- Institute of Pathology, University Hospital Essen, University Duisburg-Essen, 45122 Essen, Germany; (F.D.); (K.M.); (S.T.)
| | - Martin Ebinger
- Department of Pediatric Hematology and Oncology, Children’s University Hospital Tübingen, 72076 Tübingen, Germany; (I.B.B.); (M.E.)
| | - Gudrun Fleischhack
- Department of Pediatric Hematology and Oncology, University Hospital Essen, University Duisburg Essen, 45122 Essen, Germany; (S.D.-M.); (G.F.); (T.R.); (S.S.); (R.W.); (D.R.)
| | - Desiree Grabow
- Division of Childhood Cancer Epidemiology, German Childhood Cancer Registry at Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany;
| | - Dirk Geismar
- Clinic for Particle Therapy, West German Proton Therapy Centre Essen (WPE), University Hospital Essen, 45122 Essen, Germany; (D.G.); (B.T.)
| | - Sophia Göricke
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, 45122 Essen, Germany; (S.G.); (S.S.)
| | - Maja Guberina
- Department for Radiotherapy, University Hospital Essen, 45122 Essen, Germany;
| | - Claudia H. D. Le Guin
- Department of Ophthalmology, University Hospital Essen, University Duisburg Essen, 45122 Essen, Germany; (E.B.); (C.H.D.L.G.); (T.K.); (S.S.); (N.B.); (N.B.)
| | - Tobias Kiefer
- Department of Ophthalmology, University Hospital Essen, University Duisburg Essen, 45122 Essen, Germany; (E.B.); (C.H.D.L.G.); (T.K.); (S.S.); (N.B.); (N.B.)
| | - Christian P. Kratz
- Department of Pediatric Hematology and Oncology, Hannover Medical School, 30625 Hannover, Germany;
| | - Klaus Metz
- Institute of Pathology, University Hospital Essen, University Duisburg-Essen, 45122 Essen, Germany; (F.D.); (K.M.); (S.T.)
| | - Bert Müller
- Department of Ophthalmology, Charité-Universitätsmedizin, 13353 Berlin, Germany;
| | - Tatsiana Ryl
- Department of Pediatric Hematology and Oncology, University Hospital Essen, University Duisburg Essen, 45122 Essen, Germany; (S.D.-M.); (G.F.); (T.R.); (S.S.); (R.W.); (D.R.)
| | - Marc Schlamann
- Department of Neuroradiology, University Hospital Köln, 50937 Köln, Germany;
| | - Sabrina Schlüter
- Department of Ophthalmology, University Hospital Essen, University Duisburg Essen, 45122 Essen, Germany; (E.B.); (C.H.D.L.G.); (T.K.); (S.S.); (N.B.); (N.B.)
| | - Stefan Schönberger
- Department of Pediatric Hematology and Oncology, University Hospital Essen, University Duisburg Essen, 45122 Essen, Germany; (S.D.-M.); (G.F.); (T.R.); (S.S.); (R.W.); (D.R.)
| | - Johannes H. Schulte
- Department of Pediatric Hematology and Oncology, Charité-Universitätsmedizin, 13353 Berlin, Germany; (M.R.); (J.H.S.); (A.E.)
| | - Selma Sirin
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, 45122 Essen, Germany; (S.G.); (S.S.)
| | - Daniela Süsskind
- Department of Ophthalmology, University Hospital Tübingen, 72076 Tübingen, Germany;
| | - Beate Timmermann
- Clinic for Particle Therapy, West German Proton Therapy Centre Essen (WPE), University Hospital Essen, 45122 Essen, Germany; (D.G.); (B.T.)
- German Consortium for Translational Cancer Research (DKTK), Standort Essen/Düsseldorf, 45122 Essen, Germany;
| | - Saskia Ting
- Institute of Pathology, University Hospital Essen, University Duisburg-Essen, 45122 Essen, Germany; (F.D.); (K.M.); (S.T.)
| | - Werner Wackernagel
- Department of Ophthalmology, Medical University of Graz, 8036 Graz, Austria;
| | - Regina Wieland
- Department of Pediatric Hematology and Oncology, University Hospital Essen, University Duisburg Essen, 45122 Essen, Germany; (S.D.-M.); (G.F.); (T.R.); (S.S.); (R.W.); (D.R.)
| | - Martin Zenker
- Institute of Human Genetics, University Magdeburg, 39120 Magdeburg, Germany;
| | - Michael Zeschnigk
- Institute of Human Genetics, Medical Faculty, University Duisburg-Essen, 45122 Essen, Germany;
| | - Dirk Reinhardt
- Department of Pediatric Hematology and Oncology, University Hospital Essen, University Duisburg Essen, 45122 Essen, Germany; (S.D.-M.); (G.F.); (T.R.); (S.S.); (R.W.); (D.R.)
| | - Angelika Eggert
- Department of Pediatric Hematology and Oncology, Charité-Universitätsmedizin, 13353 Berlin, Germany; (M.R.); (J.H.S.); (A.E.)
| | - Petra Ritter-Sovinz
- Division of Pediatric Hematology/Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, 8036 Graz, Austria;
| | - Dietmar R. Lohmann
- German Consortium for Translational Cancer Research (DKTK), Standort Essen/Düsseldorf, 45122 Essen, Germany;
- Institute of Human Genetics, Medical Faculty, University Duisburg-Essen, 45122 Essen, Germany;
| | - Norbert Bornfeld
- Department of Ophthalmology, University Hospital Essen, University Duisburg Essen, 45122 Essen, Germany; (E.B.); (C.H.D.L.G.); (T.K.); (S.S.); (N.B.); (N.B.)
| | - Nikolaos Bechrakis
- Department of Ophthalmology, University Hospital Essen, University Duisburg Essen, 45122 Essen, Germany; (E.B.); (C.H.D.L.G.); (T.K.); (S.S.); (N.B.); (N.B.)
- German Consortium for Translational Cancer Research (DKTK), Standort Essen/Düsseldorf, 45122 Essen, Germany;
| | - Petra Ketteler
- Department of Pediatric Hematology and Oncology, University Hospital Essen, University Duisburg Essen, 45122 Essen, Germany; (S.D.-M.); (G.F.); (T.R.); (S.S.); (R.W.); (D.R.)
- German Consortium for Translational Cancer Research (DKTK), Standort Essen/Düsseldorf, 45122 Essen, Germany;
- Institute of Human Genetics, Medical Faculty, University Duisburg-Essen, 45122 Essen, Germany;
- Correspondence:
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Feasibility of Proton Beam Therapy as a Rescue Therapy in Heavily Pre-Treated Retinoblastoma Eyes. Cancers (Basel) 2021; 13:cancers13081862. [PMID: 33924716 PMCID: PMC8069965 DOI: 10.3390/cancers13081862] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 04/09/2021] [Accepted: 04/11/2021] [Indexed: 11/16/2022] Open
Abstract
Simple Summary A variety of therapies are available for the treatment of retinoblastomas. Nevertheless, despite exhaustion of all therapeutic methods, refractory or recurrent courses of the disease occur. In eyes with a function worthy of preservation radiation therapy may become unavoidable. Proton beam therapy, compared to conventional photon-based radiotherapy, is a highly conformal form of radiation therapy with a high biological effectiveness with a simultaneously reduced probability of radiation-related side-effects and induction of secondary primary malignancies. The aim of our retrospective study was to evaluate the efficacy of proton beam therapy as rescue therapy in 15 heavily pretreated retinoblastoma eyes. In our retrospective series of a highly negatively selected patient population, we were able to preserve 60% of the eyes with a manageable side effect profile. A cataract, as the most common long-term complication, was evident in 44.4% of the preserved eyes. There was no in-field second tumor manifestation during follow-up, therefore the preliminary data of this study and series published by others suggest that the risk is significantly lower after proton beam therapy compared to conventional external beam radiation therapy using photons. Abstract Despite the increased risk of subsequent primary tumors (SPTs) external beam radiation (EBRT) may be the only therapeutic option to preserve a retinoblastoma eye. Due to their physical properties, proton beam therapy (PBT) offers the possibility to use the effectiveness of EBRT in tumor treatment and to decisively reduce the treatment-related morbidity. We report our experiences of PBT as rescue therapy in a retrospectively studied cohort of 15 advanced retinoblastoma eyes as final option for eye-preserving therapy. The average age at the initiation of PBT was 35 (14–97) months, mean follow-up was 22 (2–46) months. Prior to PBT, all eyes were treated with systemic chemotherapy and a mean number of 7.1 additional treatments. Indication for PBT was non-feasibility of intra-arterial chemotherapy (IAC) in 10 eyes, tumor recurrence after IAC in another 3 eyes and diffuse infiltrating retinoblastoma in 2 eyes. Six eyes (40%) were enucleated after a mean time interval of 4.8 (1–8) months. Cataract formation was the most common complication affecting 44.4% of the preserved eyes, yet 77.8% achieved a visual acuity of >20/200. Two of the 15 children treated developed metastatic disease during follow-up, resulting in a 13.3% metastasis rate. PBT is a useful treatment modality as a rescue therapy in retinoblastoma eyes with an eye-preserving rate of 60%. As patients are at lifetime risk of SPTs consistent monitoring is mandatory.
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Yang MK, Lee MJ, Kim N, Choung H, Khwarg SI. Outcomes of enucleation and porous polyethylene orbital implant insertion in patients with paediatric retinoblastoma: a long-term follow-up study. Br J Ophthalmol 2020; 106:502-509. [PMID: 33293268 DOI: 10.1136/bjophthalmol-2020-317934] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 10/21/2020] [Accepted: 11/17/2020] [Indexed: 11/03/2022]
Abstract
BACKGROUND/AIMS To report the long-term outcomes of enucleation and insertion of porous polyethylene (PP) orbital implant according to the evolving surgical techniques and implant in patients with paediatric retinoblastoma . METHODS Patients with paediatric retinoblastoma who underwent enucleation and PP implant insertion from December 1998 to December 2014 were retrospectively reviewed and divided into four groups: group A, classic enucleation +PP implant; group B, enucleation +PP implant +anterior closure of the posterior Tenon's (ACPT) capsule; group C, enucleation +PP implant +free orbital fat graft +ACPT and group D, enucleation +smooth surface tunnel PP implant +ACPT. Survival analysis of implant exposure and eyelid malpositions was performed. RESULTS One hundred and ninety-eight eyes of 196 patients were included. The median follow-up period was 13.0 years (range, 5.0-21.1). A 20 mm implant was inserted for 149 eyes (75.3%). The 10-year exposure-free survival probabilities were 44.6% in group A, 96.4% in group B, 97.4% in group C and 97.7% in group D. ACPT was associated with significant reduction in implant exposure (p<0.001). The most common eyelid malposition was upper eyelid ptosis (24.2%). The eyelid malposition-free survival probability did not differ among the four groups. However, the insertion of a 20 mm implant was associated with significant reduction in upper eyelid ptosis and lower eyelid entropion (p=0.004 and 0.038, respectively). CONCLUSIONS The long-term postenucleation implant exposure was rare after PP implant insertion and ACPT, even with a 20 mm-diameter implant. A larger implant can be beneficial in long-term prevention of eyelid malposition.
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Affiliation(s)
- Min Kyu Yang
- Department of Ophthalmology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Min Joung Lee
- Department of Ophthalmology, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
| | - Namju Kim
- Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Hokyung Choung
- Department of Ophthalmology, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Seoul, Republic of Korea
| | - Sang In Khwarg
- Department of Ophthalmology, Seoul National University Hospital, Seoul, Republic of Korea
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Banerjee SC, Pottenger E, Petriccione M, Chou JF, Ford JS, Sklar CA, Robison LL, Kleinerman RA, Oeffinger KC, Francis JH, Abramson DH, Dunkel IJ, Friedman DN. Impact of enucleation on adult retinoblastoma survivors' quality of life: A qualitative study of survivors' perspectives. Palliat Support Care 2020; 18:322-331. [PMID: 31699178 PMCID: PMC7205583 DOI: 10.1017/s1478951519000920] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVES Retinoblastoma is the most common primary intraocular tumor of childhood with >95% survival rates in the US. Traditional therapy for retinoblastoma often included enucleation (removal of the eye). While much is known about the visual, physical, and cognitive ramifications of enucleation, data are lacking about survivors' perception of how this treatment impacts overall quality of life. METHODS Qualitative analysis of an open-ended response describing how much the removal of an eye had affected retinoblastoma survivors' lives and in what ways in free text, narrative form. RESULTS Four hundred and four retinoblastoma survivors who had undergone enucleation (bilateral disease = 214; 52% female; mean age = 44, SD = 11) completed the survey. Survivors reported physical problems (n = 205, 50.7%), intrapersonal problems (n = 77, 19.1%), social and relational problems (n = 98, 24.3%), and affective problems (n = 34, 8.4%) at a mean of 42 years after diagnosis. Three key themes emerged from survivors' responses; specifically, they (1) continue to report physical and intrapersonal struggles with appearance and related self-consciousness due to appearance; (2) have multiple social and relational problems, with teasing and bullying being prominent problems; and (3) reported utilization of active coping strategies, including developing more acceptance and learning compensatory skills around activities of daily living. SIGNIFICANCE OF RESULTS This study suggests that adult retinoblastoma survivors treated with enucleation continue to struggle with a unique set of psychosocial problems. Future interventions can be designed to teach survivors more active coping skills (e.g., for appearance-related issues, vision-related issues, and teasing/bullying) to optimize survivors' long-term quality of life.
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Affiliation(s)
- Smita C. Banerjee
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medical College, New York, NY, USA
| | | | | | - Joanne F Chou
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jennifer S Ford
- Hunter College and The Graduate Center, City University of New York, New York, NY, USA
| | - Charles A Sklar
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medical College, New York, NY, USA
| | | | | | | | | | - David H Abramson
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medical College, New York, NY, USA
| | - Ira J Dunkel
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medical College, New York, NY, USA
| | - Danielle Novetsky Friedman
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medical College, New York, NY, USA
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Quality of Life (QoL) and Psychosocial Outcomes in Adult Survivors of Unilateral Retinoblastoma (RB) in China. J Ophthalmol 2020; 2020:4384251. [PMID: 32280521 PMCID: PMC7125462 DOI: 10.1155/2020/4384251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 02/12/2020] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To assess the quality of life (QoL) and the long-term psychosocial outcomes in adult survivors of unilateral retinoblastoma (RB). METHODS This is a cross-sectional study. Enrolment was offered to all adult survivors of unilateral RB who were treated by enucleation and were followed up in the Ninth People's Hospital of Shanghai Jiao Tong University School of Medicine; noncancer healthy adults served as a control group. All participants completed a series of questionnaires consisting of two aspects, QoL and psychosocial status. The psychosocial outcomes included anxiety, depression, fear of cancer, and satisfaction with facial appearance. RESULTS A total of 66 RB survivors (43.0% male) and 66 healthy adults (33.3% male) were aged 27.94 ± 7.63 and 29.18 ± 8.37 at the time of the study, respectively. Adult RB survivors did not have significantly higher rates of depression and anxiety compared with the control group, and they experienced a relatively good QoL. RB survivors were more likely to worry about their facial appearance (median, 1.59 [inter-quartile range, IQR, 1.27 to 2.16] v median, 0.36 [IQR, 0.09 to 1.18]; p < 0.001). Radiotherapy was not the factor affecting satisfaction with facial appearance (β, -0.27 [confidence interval, CI, -0.69 to 0.16]; p < 0.001). Radiotherapy was not the factor affecting satisfaction with facial appearance (p < 0.001). Radiotherapy was not the factor affecting satisfaction with facial appearance (p < 0.001). Radiotherapy was not the factor affecting satisfaction with facial appearance (. CONCLUSIONS Unilateral RB survivors are a fairly healthy and resilient group. Most unilateral RB survivors experience a relatively good QoL, and they do not have poorer psychosocial functioning compared with a noncancer sample. Females may need more specific psychosocial care.
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Taneja S, Aldoais T, Kaliki S. Primary orbital polymethylmethacrylate implant following primary enucleation for retinoblastoma: a study of 321 cases. Orbit 2020; 40:127-132. [PMID: 32252576 DOI: 10.1080/01676830.2020.1750040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose: To evaluate the outcome of primary orbital polymethylmethacrylate (PMMA) implant following the primary enucleation for retinoblastoma. Methods: Retrospective study of 321 retinoblastoma patients who underwent unilateral enucleation and PMMA implant for retinoblastoma by myoconjunctival technique. Outcome measures included implant centration and extrusion. Results: The mean age at the time of enucleation of patients with retinoblastoma was 35 months (median, 30 months; range, <1 to 449 months). After primary enucleation, primary orbital PMMA implant was used in all cases. The mean diameter of implant was 18 mm (median, 18 mm; range, 12-20 mm) and the mean horizontal diameter of the socket conformer was 24 mm (median, 24 mm; range, 18 mm-26 mm). Post-enucleation and implant, seven (2%) patients underwent orbital external beam radiotherapy owing to microscopic extrascleral tumor extension or tumor infiltration of optic nerve transection. Over a mean follow-up period of 40 months (median, 34 months; range, 4-129 months), implant migration was noted in 28 (9%) patients, implant extrusion in 9 (3%), and implant exposure in 5 (2%), and contracted socket in 5 (2%) patients including grade 1 contraction in 3 (1%), grade 2 in 1 (<1%), and grade 4 in 1 (<1%) patient. Implant exchange for an improved prosthesis fit was performed in 4 (1%) cases. Stable customized ocular prosthesis was achieved in all but one patient. Conclusion: Primary orbital PMMA implant following primary enucleation for retinoblastoma is associated with minimal complications and provides acceptable cosmetic outcomes.
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Affiliation(s)
- Shikha Taneja
- The Operation Eyesight Universal Institute for Eye Cancer (ST, TA, SK), L V Prasad Eye Institute , Hyderabad, India
| | - Tariq Aldoais
- The Operation Eyesight Universal Institute for Eye Cancer (ST, TA, SK), L V Prasad Eye Institute , Hyderabad, India
| | - Swathi Kaliki
- The Operation Eyesight Universal Institute for Eye Cancer (ST, TA, SK), L V Prasad Eye Institute , Hyderabad, India
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