Orbital growth retardation in retinoblastoma survivors: work in progress.
BACKGROUND
Orbital growth retardation, after enucleation and/or external beam radiation for retinoblastoma (RB), is a serious late effect. We measured orbital volumes of RB survivors treated at Hadassah University Hospital, Jerusalem, between 1980-1998.


METHODS
Forty-five orbits of 28 children with RB (17 bilateral, 11 unilateral) were examined. Thirty-six orbits were irradiated, 19 enucleated, and 10 both enucleated and irradiated. The orbital volumes were calculated from a three-dimensional orbital CT reconstruction. The orbits of RB survivors were compared to age-matched controls.


RESULTS
The mean age at diagnosis was 13 months, mean follow-up time was 56 months. The mean volume of RB orbits (14.4 cc) was statistically significantly smaller than control orbits (17.8 cc). There was no difference between the mean volume of orbits treated with enucleation, irradiation or both. The orbital volume of children treated before the age of 12 months was statistically significantly smaller than those treated later. There was no difference between mean volume of fellow orbits in unilateral RB and controls. The mean orbital asymmetry index in control children (2.6%) was statistically significantly smaller than in RB survivors (14%).


CONCLUSIONS
There was a significant orbital growth retardation after enucleation and/or irradiation for RB. There was no difference between mean orbital volumes after enucleation, radiation or both. Orbital growth retardation was most prominent in children treated in the first year of life. Although small in number, our study suggests that deferring enucleation and/or irradiation until after the age of 12 months may reduce long-term complications.
Peylan-Ramu
N
N
Department of Oncology, Hadassah University Hospital, and Hebrew University-Hadassah Medical School, Jerusalem, Israel. ramu@hadassah.org.il
Bin-Nun
A
A
Skleir-Levy
M
M
Bibas
A
A
Koplewitz
B
B
Anteby
I
I
Pe'er
J
J
D000367:Age Factors; D002675:Child, Preschool; D003131:Combined Modality Therapy; D015353:Eye Enucleation / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D009915:Orbit / Q000254:growth & development* / Q000528:radiation effects; D011183:Postoperative Complications; D011878:Radiotherapy / Q000009:adverse effects; D019572:Retinal Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D012175:Retinoblastoma / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*