Socioeconomic impact of modern multidisciplinary management of retinoblastoma.
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.
Wilson
Matthew W
MW
Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, Tennessee, USA. mwilson5@utmem.edu
Haik
Barrett G
BG
Rodriguez-Galindo
Carlos
C
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
D014750:Vincristine; D016190:Carboplatin