Retinoblastoma patient outcomes in the contemporary era: The RIVERBOAT Consortium.
Notice bibliographique
Résumé
10062 Background: Retinoblastoma (RB) is the most common childhood eye tumor. Intraocular RB cure rates approach 100%. Therefore, treatment now focuses on globe salvage and preserving functional vision. The Research into Visual Endpoints and RB Health Outcomes After Treatment (RIVERBOAT) consortium was established to examine patient outcomes in the transitional era from systemic to intraocular therapy. Methods: Patients with RB treated at 13 North American centers from 2008-2022 were identified. Medical record abstraction was performed for disease presentation, visual acuity, treatment, globe salvage and functional outcome. Enrollment on the study included submission of retrospective data and prospective data on newly diagnosed patients as well as retrospective data from chart reviews. Results: 830 patients (68% white race, 77% non-Hispanic ethnicity) were enrolled. In 420 of these, data was limited to chart review. Median age at diagnosis of the 830 patients (1165 eyes) was 1 year (0 - 16.3) and at enrollment was 7.8 years (0 - 28.6). 60% had unilateral disease and the eye group distribution (International Intraocular Retinoblastoma Classification) was 10% A, 16% B, 12% C, 31% D, 27% E, and 4% unknown (UK). Of the 1165 affected eyes, major treatment modalities included primary enucleation (15%), systemic chemotherapy (SC) (36%), intraarterial chemotherapy (IAC) (10%), SC followed by IAC in 9%, and intravitreal chemotherapy in combination in 6%. SC only was used in 55-59% of those with A-C eyes compared to 29% of D eyes. IAC only was used in 20% of D eyes and 16% of C eyes. Secondary enucleation occurred in 151 eyes (14%): 63/416 (15%) of SC; 34/120 (28%) of IAC; 25/106 (24%) of SC followed by IAC; 29/523 (6%) other treatments. The overall globe salvage rate was 86%. Second malignancies occurred in 5, metastatic disease in 8 and pineoblastoma in 3 patients. Eleven patients died of RB (1%). Visual acuity after treatment was reported in 229 eyes: 106 (eye group 24 A, 37 B, 22 C, 19 D, 3 E, 1 UK) had normal vision (20/20-20/40). 38 eyes, (6 A, 11 B, 4 C, 10 D, 5 E, 2 UK) had moderate vision loss ( > 20/40 – 20/70). Twenty-five eyes (5 B, 2 C, 16 D, 2 E) had low vision ( > 20/70 < 20/200), and 60 eyes (12 B, 7 C, 32 D, 8 E, 1 UK) were legally blind (>20/200). In those treated with IAC only, normal vision was found in 30% of eyes, moderate vision loss in 22%, low vision in 13%, and legal blindness in 35%. In those treated with SC only, normal vision was noted in 53% of eyes, moderate vision loss in 11%, low vision in 11%, and legal blindness in 25%. In those treated with SC followed by IAC, normal vision was reported in 32%, moderate vision in 26%, low vision in 5% and legal blindness in 37%. Conclusions: We demonstrate the significant benefits witnessed by the evolution of RB therapy. Cure rates remain high, with a very low incidence of second malignancies, metastatic disease or trilateral RB. Eye salvage rate was excellent, avoiding low vision or legal blindness in two-thirds of the patients.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,003 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,002 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».