Yousef Yacoub A, Abu Salim Qusai F, Mohammad Mona, Jaradat Imad, Mehyar Mustafa, AlJabari Reem, Al-Habahbeh Omar, Saboubeh Khalid, Halalsheh Hadeel, Khzouz Jakub, Shawagfeh Munir, Sultan Iyad, AlMasri Mahmoud, Al-Nawaiseh Ibrahim, Al-Hussaini Maysa, Mansour Asem
Department of Surgery, King Hussein Cancer Centre (KHCC), Amman, Jordan.
Department Radiation Oncology, King Hussein Cancer Centre (KHCC), Amman, Jordan.
Front Oncol. 2023 Jan 13;12:1056963. doi: 10.3389/fonc.2022.1056963. eCollection 2022.
The humanitarian crisis in Syria has had a profound impact on the entire region. In this study, we report the patterns of presentation and management outcomes of Syrian patients with Retinoblastoma (Rb) treated at a single tertiary cancer center in Jordan.
This is a retrospective comparative study of Syrian refugees and Jordanian citizens who had Rb between 2011 and 2020. Collected data included patient demographics, presentation, tumor stage, treatment modalities, eye salvage rate, metastasis, and mortality.
Thirty Syrian refugees (16 (53%) had bilateral disease) and 124 Jordanian citizens (51(41%) had bilateral disease) were diagnosed with Rb during this period. The median age at diagnosis for refugees was 10 and 32 months for patients with bilateral and unilateral Rb consecutively, compared to 6 and 28 months for citizens. The median lag time between signs of disease and initiation of treatment was 3 months for refugees, compared to 1 month for citizens.Refugees were more likely to present with a more advanced stage (p=0.046). Out of 46 affected eyes in refugees; 32 (70%) eyes were group D or E, while out of 175 affected eyes among citizens; 98 (56%) eyes were group D or E. Therefore, refugees with Rb were more likely to mandate primary enucleation (48%) compared to citizens (25%) (p=0.003). However, out of 24 eyes among refugees who received conservative therapy, 15 (62%) eyes were successfully salvaged, while out of 131 affected eyes among citizens who received conservative therapy, 105 (80%) eyes were successfully salvaged (p=0.06). Two (7%) of the refugees and four (3.2%) of the citizens with Rb died from metastasis.
Syrian refugees with Rb presented with more advanced disease due to delay in diagnosis and referral that increased the treatment burden by decreasing the chance for eye globe salvage. However, patients who received the timely intervention had a similar outcome to citizens with Rb; probably a reflection of the management of all patients at a single specialized center. We advocate for the timely referral of refugees with this rare life-threatening tumor to a specialized cancer center for the best possible outcome.
叙利亚的人道主义危机对整个地区产生了深远影响。在本研究中，我们报告了在约旦一家单一的三级癌症中心接受治疗的叙利亚视网膜母细胞瘤（Rb）患者的临床表现模式和治疗结果。
这是一项对2011年至2020年间患有Rb的叙利亚难民和约旦公民的回顾性比较研究。收集的数据包括患者人口统计学信息、临床表现、肿瘤分期、治疗方式、眼球挽救率、转移情况和死亡率。
在此期间，30名叙利亚难民（16名（53%）患有双侧疾病）和124名约旦公民（51名（41%）患有双侧疾病）被诊断患有Rb。难民中双侧和单侧Rb患者的诊断中位年龄分别为10个月和32个月，而公民分别为6个月和28个月。难民从出现疾病症状到开始治疗的中位延迟时间为3个月，而公民为1个月。难民更有可能表现为疾病分期更晚（p = 0.046）。在难民的46只患眼中，32只（70%）为D组或E组，而在公民的175只患眼中，98只（56%）为D组或E组。因此，与公民（25%）相比，患有Rb的难民更有可能接受一期眼球摘除术（48%）（p = 0.003）。然而，在接受保守治疗的难民的24只眼中，15只（62%）眼球成功挽救，而在接受保守治疗的公民的131只患眼中，105只（80%）眼球成功挽救（p = 0.06）。两名（7%）患有Rb的难民和四名（3.2%）患有Rb的公民死于转移。
患有Rb的叙利亚难民由于诊断和转诊延迟，表现为疾病更晚期，这通过降低眼球挽救机会增加了治疗负担。然而，接受及时干预的患者与患有Rb的公民有相似的结果；这可能反映了在单一专业中心对所有患者的管理情况。我们主张将患有这种罕见的危及生命肿瘤的难民及时转诊至专业癌症中心，以获得最佳可能结果。
