Casey Anthea, Barliana Julie Dewi
Research Assistant, Pediatric Ophthalmology Division, Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Pediatric Ophthalmologist, Pediatric Ophthalmology Division, Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Taiwan J Ophthalmol. 2024 Feb 2;15(1):45-54. doi: 10.4103/tjo.TJO-D-23-00086. eCollection 2025 Jan-Mar.
Secondary neoplasms are a significant cause of mortality among retinoblastoma survivors, particularly when exposed to radiation. This systematic review aims to investigate the association between radiation exposure and the incidence of secondary neoplasms in retinoblastoma survivors. A comprehensive literature search was conducted using PubMed, ProQuest, and EBSCOhost databases to gather relevant studies. Studies written in English about the incidence of secondary neoplasms in retinoblastoma patients who underwent radiotherapy were included. Retinoblastoma patients who did not receive radiotherapy were regarded as the control group. Studies involving animals and those without a control group were excluded. No date restrictions were applied. The last search was performed on April 6, 2022. The study selection process was presented in a flow diagram following the Preferred Reporting Items of Systematic reviews Meta-Analysis 2020 guidelines. The risk of bias was evaluated using the Risk of Bias in nonrandomized Studies of Interventions tool. Statistical analysis was performed using the Cochrane RevMan software (version 5.4.1). Five studies comprising a total of 3324 retinoblastoma patients were included. Of these, 290 (8.72%) patients developed secondary neoplasms, with 250 (86.21%) receiving radiotherapy. The results indicated that retinoblastoma patients who received radiotherapy had a higher risk of developing secondary neoplasms, with a pooled risk ratio of 5.12 (95% confidence interval 3.56-7.36, = 14%). The findings of this review highlight the importance of considering the risk of developing secondary neoplasms when treating retinoblastoma. Regular medical surveillance for secondary neoplasms should be a standard part of care for retinoblastoma survivors, particularly those exposed to radiation.
继发性肿瘤是视网膜母细胞瘤幸存者死亡的一个重要原因，尤其是在接受放疗的情况下。本系统综述旨在研究放疗暴露与视网膜母细胞瘤幸存者继发性肿瘤发生率之间的关联。使用PubMed、ProQuest和EBSCOhost数据库进行了全面的文献检索，以收集相关研究。纳入了用英文撰写的关于接受放疗的视网膜母细胞瘤患者继发性肿瘤发生率的研究。未接受放疗的视网膜母细胞瘤患者被视为对照组。排除涉及动物的研究和没有对照组的研究。未设置日期限制。最后一次检索于2022年4月6日进行。研究选择过程按照《系统评价和Meta分析优先报告条目2020指南》以流程图形式呈现。使用干预性非随机研究的偏倚风险工具评估偏倚风险。使用Cochrane RevMan软件（5.4.1版）进行统计分析。纳入了五项研究，共3324例视网膜母细胞瘤患者。其中，290例（8.72%）患者发生了继发性肿瘤，250例（86.21%）接受了放疗。结果表明，接受放疗的视网膜母细胞瘤患者发生继发性肿瘤的风险更高，合并风险比为5.12（95%置信区间3.56 - 7.36， = 14%）。本综述的结果突出了在治疗视网膜母细胞瘤时考虑发生继发性肿瘤风险的重要性。对继发性肿瘤进行定期医学监测应成为视网膜母细胞瘤幸存者护理的标准组成部分，尤其是那些接受过放疗的患者。
