From the Departments of Ophthalmology and Visual Sciences, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA.
From the Departments of Ophthalmology and Visual Sciences, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA; Pediatrics, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA.
Am J Ophthalmol. 2021 Sep;229:266-273. doi: 10.1016/j.ajo.2021.04.025. Epub 2021 May 7.
The purpose of this study was to describe the academic performance of childhood retinoblastoma (RB) survivors.
Retrospective cohort study.
Retrospective chart review of children followed in a survivorship clinic.
A total of 73 patients with RB (median age at diagnosis: 9.97 months; range: 0.29-65.1) were followed for a median of 6.4 years (0.2-1.76). A total of 48 patients (65.8%) had unilateral RB; 43 patients (63.0%) received systemic chemotherapy; and 57 patients (78.1%) underwent enucleation. At last follow-up, 5 children (6.8%) had bilateral visual acuity (VA) <20/70. Seventeen subjects (23.3%) reported school difficulties, and 10 subjects (13.7%) had an individualized education program (IEP). Multivariate analysis revealed that a history of receiving chemotherapy" Multivariate analysis revealed that a history of receiving chemotherapy was associated with self-reported school difficulties (odds ratio [CI]: 5.44; 95% confidence interval [CI]: 1.36-21.69; P = .016), and undergoing an IEP (OR: 11.47; 95% CI: 1.34-98.16; P = .03). The degree of visual impairment and history of enucleation did not influence the risk of self-reported school difficulties or the implementation of an IEP. Among unilateral RB patients, chemotherapy was an independent risk factor for self-reported school difficulties (OR: 12.8; 95% CI: 1.45-113; P = .009) and implementation of an IEP (OR: 15.2; 95% CI: 0.78-292; P = .02).
Academic difficulties in childhood RB survivors are associated with chemotherapy treatment, a risk factor independent of VA.
本研究旨在描述儿童视网膜母细胞瘤（RB）幸存者的学业表现。
回顾性队列研究。
对在生存诊所接受随访的儿童进行回顾性图表审查。
共纳入 73 例 RB 患儿（诊断时中位年龄：9.97 个月；范围：0.29-65.1 岁），中位随访时间为 6.4 年（0.2-1.76 年）。共有 48 例患儿（65.8%）为单侧 RB；43 例患儿（63.0%）接受全身化疗；57 例患儿（78.1%）行眼球摘除术。末次随访时，5 例患儿（6.8%）双侧视力（VA）<20/70。17 例患儿（23.3%）自述学习困难，10 例患儿（13.7%）有个别化教育计划（IEP）。多变量分析显示，化疗史与自述学习困难相关（比值比[CI]：5.44；95%置信区间[CI]：1.36-21.69；P=0.016），并与 IEP 相关（OR：11.47；95% CI：1.34-98.16；P=0.03）。视力损害程度和眼球摘除术史并不影响自述学习困难或 IEP 的实施风险。在单侧 RB 患儿中，化疗是自述学习困难（OR：12.8；95% CI：1.45-113；P=0.009）和 IEP 实施（OR：15.2；95% CI：0.78-292；P=0.02）的独立危险因素。
儿童 RB 幸存者的学业困难与化疗治疗相关，是视力以外的独立危险因素。
