title: Socioeconomic impact of modern multidisciplinary management of retinoblastoma.
abstract: 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.
authors.affiliation: Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, Tennessee, USA. mwilson5@utmem.edu
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Wilson
authors.forename: Barrett G
authors.initials: BG
authors.lastname: Haik
authors.forename: Carlos
authors.initials: C
authors.lastname: Rodriguez-Galindo
mesh_terms: D000768:Anesthesia, General / Q000191:economics / Q000706:statistics & numerical data; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000191:economics / Q000627:therapeutic use*; D001918:Brachytherapy / Q000191:economics / Q000706:statistics & numerical data; D016190:Carboplatin / Q000008:administration & dosage; D019090:Case Management / Q000191:economics; D002405:Catheterization, Central Venous / Q000191:economics / Q000706:statistics & numerical data; D002675:Child, Preschool; D002986:Clinical Trials as Topic; D015331:Cohort Studies; D003131:Combined Modality Therapy; D003952:Diagnostic Imaging / Q000191:economics / Q000706:statistics & numerical data; D016527:Drug Costs; D015353:Eye Enucleation / Q000191:economics / Q000706:statistics & numerical data; D005134:Eye Neoplasms / Q000188:drug therapy* / Q000191:economics / Q000532:radiotherapy / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D017721:Hospital Costs; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009378:Neoplasms, Multiple Primary / Q000188:drug therapy / Q000191:economics / Q000532:radiotherapy / Q000601:surgery; D009819:Office Visits / Q000191:economics / Q000706:statistics & numerical data; D010348:Patient Care Team / Q000191:economics; D018714:Radiotherapy, Adjuvant / Q000191:economics / Q000706:statistics & numerical data; D012175:Retinoblastoma / Q000188:drug therapy* / Q000191:economics / Q000532:radiotherapy / Q000601:surgery; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D014195:Travel / Q000191:economics; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D014750:Vincristine; D016190:Carboplatin