The Clinical Study Of Intra-arterial Chemotherapy For Retinoblastoma

Objective:To analyze globe salvage time and life survival time for Intra-arterial chemotherapy(IAC)management retinoblastoma(RB)patients and to understand the determinates of the prognosis for such patient and to provide reliable evidence for clinical assessment and individualized treatment.Method:The retrospective cohort study was conducted among patients with RB data in Guangzhou woman and children hospital from the year of April 1,2009,to April 1,2016,A total of 305 eyes of 271 patients with unilateral or bilateral retinoblastoma were treated.The clinical characteristics and treatment situation and the life and globe salvage rate and life survival rate were involved in this study.The Kaplan Meier survival curve was to estimate eyes survival time and life survival time for patient and univariate analyses was performed to compare between gender,IIRC,age,treatment history clinical curative effect.Cox proportional hazard model was conducted to explore the determinants of prognosis for patients with RB.Results: A total of 271 cases of RB data were followed-up for a median of 15 months(range:1-96 months),since the date of last IAC,the survival time for the patients had been from 1 months to 96 months,There were 943 IAC(median,3 per eye),246 survival(5 years life survival rate 92.8%),The Kaplan-Meier estimate of globe salvage rate was 63.1% at 5 years.Specifically,according to the International Intraocular Retinoblastoma Classification(IIRC)as group A(n=1)group B(n=12),group C(n=22)both achieved globe salvage for 100%,group D(n=208)for 77.4% at 1 years,74.1% at 2years,70.0% at 3years,64.1% at 5years,group E(42)for 42.9% at 1 years,32.2% at 2years,26.8% at 3years,26.8% at 5 years,Univarite analysis showed that be salvage rate was significantly associated with IIRC,Age,treatment history were not associated with globe salvage rate with RB,The finding from Cox proportional hazard model showed that IIRC(RR3.866,95% confidence interval,2.558-5.843)were independent determinants for RB.Conclusion: Intra-arterial chemotherapy is safe and effective for management of retinoblastoma.This research shows that the Kaplan-Meier estimate of Globe salvage rate was 70.2% at 5 years,life survival rate 94.5%,IIRC can be used for the assessment of prognosis,Age,treatment history were not associated with globe salvage rate with RB,provide reliable evidence for clinical assessment and individualized treatment.