title: First-year experience of chemotherapy for advanced retinoblastoma in Tanzania: disease profile, outcomes, and challenges in 2008.
abstract: OBJECTIVE
  To examine the profile of retinoblastoma in a national tertiary referral center in Tanzania and to report first-year outcomes of its treatment using chemotherapy.
  
  
  METHODS
  All patients with retinoblastoma referred in 2008 were included. Disease was classified on clinical grounds as ocular, orbital, or metastatic. Those with ocular and orbital disease received chemotherapy. Remission was the main outcome measure and defined as absence of disease at the end of treatment.
  
  
  RESULTS
  In 2008, 37 patients (20 males and 17 females) with retinoblastoma were referred to Ocean Road Cancer Institute. The mean delay from the first sign of disease to presentation at hospital was 10.4 ± 8.7 months. Disease was ocular in 32% (12 of 37), orbital in 57% (21 of 37), and metastatic in 11% (4 of 37). Of those with ocular disease, 67% (8 of 12) completed chemotherapy and all (8 of 8) achieved remission. In contrast, 48% (10 of 21) with orbital disease completed chemotherapy and only 50% (5 of 10) achieved remission. The difference in outcome between the groups was statistically significant (P = .001, Fisher exact test).
  
  
  CONCLUSIONS
  The profile of retinoblastoma in Tanzania is skewed toward severe invasive disease. Despite the introduction of chemotherapy, further improvements in mortality and morbidity can only be achieved through emphasis on early detection.
authors.affiliation: Dept. of Ophthalmology, St. James’s University Hospital, Leeds, United Kingdom. zia.carrim@doctors.org.uk
authors.forename: Zia I
authors.initials: ZI
authors.lastname: Carrim
authors.forename: Jane
authors.initials: J
authors.lastname: Kajaige
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Bowman
authors.forename: Tim E
authors.initials: TE
authors.lastname: Lavy
authors.forename: Patricia
authors.initials: P
authors.lastname: Scanlan
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D003520:Cyclophosphamide / Q000008:administration & dosage; D015251:Epirubicin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D015353:Eye Enucleation; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008485:Medical Audit; D019572:Retinal Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D012175:Retinoblastoma / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D013636:Tanzania / Q000453:epidemiology; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D015251:Epirubicin; D014750:Vincristine; D005047:Etoposide; D003520:Cyclophosphamide; D016190:Carboplatin