Scelfo Christina, Francis Jasmine H, Khetan Vikas, Jenkins Thomas, Marr Brian, Abramson David H, Shields Carol L, Pe'er Jacob, Munier Francis, Berry Jesse, Harbour J William, Yarovoy Andrey, Lucena Evandro, Murray Timothy G, Bhagia Pooja, Paysse Evelyn, Tuncer Samuray, Chantada Guillermo L, Moll Annette C, Ushakova Tatiana, Plager David A, Ziyovuddin Islamov, Leal Carlos A, Materin Miguel A, Ji Xun-Da, Cursino Jose W, Polania Rodrigo, Kiratli Hayyam, All-Ericsson Charlotta, Kebudi Rejin, Honavar Santosh G, Vishnevskia-Dai Vicktoria, Epelman Sidnel, Daniels Anthony B, Ling Jeanie D, Traore Fousseyni, Ramirez-Ortiz Marco A
Ophthalmic Oncology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York 10065, USA.
Department of Ophthalmology, Weill-Cornell Medical Center, New York 10065, USA.
Int J Ophthalmol. 2017 Jun 18;10(6):961-967. doi: 10.18240/ijo.2017.06.20. eCollection 2017.
To determine which IIRC scheme was used by retinoblastoma centers worldwide and the percentage of D eyes treated primarily with enucleation versus globe salvaging therapies as well as to correlate trends in treatment choice to IIRC version used and geographic region.
An anonymized electronic survey was offered to 115 physicians at 39 retinoblastoma centers worldwide asking about IIRC classification schemes and treatment patterns used between 2008 and 2012. Participants were asked to record which version of the IIRC was used for classification, how many group D eyes were diagnosed, and how many eyes were treated with enucleation versus globe salvaging therapies. Averages of eyes per treatment modality were calculated and stratified by both IIRC version and geographic region. Statistical significance was determined by Chi-square, ANOVA and Kruskal-Wallis tests using Prism.
The survey was completed by 29% of physicians invited to participate. Totally 1807 D eyes were diagnosed. Regarding IIRC system, 27% of centers used the Children's Hospital of Los Angeles (CHLA) version, 33% used the Children's Oncology Group (COG) version, 23% used the Philadelphia version, and 17% were unsure. The rate for primary enucleation varied between 0 and 100% and the mean was 29%. By IIRC version, primary enucleation rates were: Philadelphia, 8%; COG, 34%; and CHLA, 37%. By geographic region, primary enucleation rates were: Latin America, 57%; Asia, 40%; Europe, 36%; Africa, 10%, US, 8%; and Middle East, 8%. However, systemic chemoreduction was used more often than enucleation in all regions except Latin America with a mean of 57% per center (<0.0001).
Worldwide there is no consensus on which IIRC version is used, systemic chemoreduction was the most frequently used initial treatment during the study period followed by enucleation and primary treatment modality, especially enucleation, varied greatly with regards to IIRC version used and geographic region.
确定全球视网膜母细胞瘤治疗中心采用的国际眼内视网膜母细胞瘤分类（IIRC）方案，以及主要采用眼球摘除术与眼球挽救疗法治疗的D期眼的比例，并将治疗选择趋势与所使用的IIRC版本及地理区域相关联。
向全球39个视网膜母细胞瘤治疗中心的115名医生提供了一份匿名电子调查问卷，询问他们2008年至2012年间使用的IIRC分类方案和治疗模式。参与者被要求记录用于分类的IIRC版本、诊断出的D期眼数量，以及采用眼球摘除术与眼球挽救疗法治疗的眼数。计算每种治疗方式的平均眼数，并按IIRC版本和地理区域进行分层。使用Prism软件通过卡方检验、方差分析和克鲁斯卡尔 - 沃利斯检验确定统计学显著性。
受邀参与的医生中有29%完成了调查。共诊断出1807只D期眼。关于IIRC系统，27%的中心使用洛杉矶儿童医院（CHLA）版本，33%使用儿童肿瘤协作组（COG）版本，23%使用费城版本，17%不确定。一期眼球摘除率在0%至100%之间，平均为29%。按IIRC版本划分，一期眼球摘除率分别为：费城版本8%；COG版本34%；CHLA版本37%。按地理区域划分，一期眼球摘除率分别为：拉丁美洲57%；亚洲40%；欧洲36%；非洲10%；美国8%；中东8%。然而，除拉丁美洲外，所有地区采用全身化疗减积法的频率均高于眼球摘除术，每个中心的平均使用率为57%（<0.0001）。
全球范围内对于使用哪种IIRC版本尚无共识，在研究期间全身化疗减积法是最常用的初始治疗方法，其次是眼球摘除术，且主要治疗方式，尤其是眼球摘除术，因所使用的IIRC版本和地理区域的不同而有很大差异。
