Download PDF
CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2022; 43(03): 250-254
DOI: 10.1055/s-0042-1750204
Original Article

Challenges in the Management of Retinoblastoma during Nationwide Lockdown: An Observational Study from a Retinoblastoma Center in South India

Janani Arul
1   Division of Pediatric Hemato-Oncology, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, Tamil Nadu, India
,
Suganeswari Ganesan
2   Department of Ophthalmology (Vitreoretina and Oncology), Sankara Nethralaya, Chennai, India
,
Vikas Khetan 
2   Department of Ophthalmology (Vitreoretina and Oncology), Sankara Nethralaya, Chennai, India
,
Latha M. Sneha
1   Division of Pediatric Hemato-Oncology, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, Tamil Nadu, India
,
Dhaarani Jayaraman
1   Division of Pediatric Hemato-Oncology, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, Tamil Nadu, India
,
Julius Xavier Scott
1   Division of Pediatric Hemato-Oncology, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, Tamil Nadu, India
› Author Affiliations Funding None.
› Further Information
Also available at
   Permissions and Reprints

Abstract

Introduction The nationwide lockdown due to coronavirus disease 2019 led to travel restrictions resulting in a delay in diagnosis, treatment, and follow-up of children with retinoblastoma (RB).

Objectives We audited the impact and challenges of lockdown among RB children over 1-year period (May 2020–2021).

Materials and Methods It is a cross-sectional study of 104 children with RB, who presented within the 1-year study period. The demographic details, clinical presentations, and outcome of treatment due to lockdown were studied.

Results Of the 152 eyes of 104 children, unilateral RB was observed in 52% and bilateral in 48%, in which four children had metastatic disease and one child had trilateral RB. International classification groups D (n = 64 eyes, 42%) and E (n = 38 eyes, 25%) were in majority. Almost, half of the children (n = 53, 51%) underwent enucleation. Overall, the vision was preserved in 32% of the children and globe preservation in 49% of children. Eleven children (10.5%) succumbed due to disease progression. But, only five children were affected with severe acute respiratory syndrome coronavirus 2 infection. The majority of children (n = 72, 69%) had to travel more than or equal to 1,000 km for treatment. About 57% (n = 60) patients were newly diagnosed during the lockdown period and due to the travel restrictions, they had a mean delay of 2.2 months (range: 0–15 months) in starting treatment and 27% (n = 29) of children on treatment had an interruption of treatment.

Conclusion Multidisciplinary team management with strategies to support the RB families during locked down crisis is essential to continue care without interruptions.

Keywords

COVID-19 - children - retinoblastoma - lockdown - travel restrictions


Publication History

Article published online:
02 July 2022

© 2022. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Sullivan M, Bouffet E, Rodriguez-Galindo C. et al; Contributing Authors. The COVID-19 pandemic: a rapid global response for children with cancer from SIOP, COG, SIOP-E, SIOP-PODC, IPSO, PROS, CCI, and St Jude Global. Pediatr Blood Cancer 2020; 67 (07) e28409
    CrossrefPubMedGoogle Scholar
  • 2 Ribeiro RC, Steliarova-Foucher E, Magrath I. et al. Baseline status of paediatric oncology care in ten low-income or mid-income countries receiving My Child Matters support: a descriptive study. Lancet Oncol 2008; 9 (08) 721-729
    CrossrefPubMedGoogle Scholar
  • 3 Bhakta N, Force LM, Allemani C. et al. Childhood cancer burden: a review of global estimates. Lancet Oncol 2019; 20 (01) e42-e53
    CrossrefPubMedGoogle Scholar
  • 4 Peter N, Bandyopadhyay S, Lakhoo K. Global Health Research Group on Children's Non-Communicable Diseases Collaborative. Impact of the COVID-19 pandemic on paediatric patients with cancer in low-income, middle-income and high-income countries: protocol for a multicentre, international, observational cohort study. BMJ Open 2021; 11 (06) e045679
    CrossrefPubMedGoogle Scholar
  • 5 Howard SC, Metzger ML, Wilimas JA. et al. Childhood cancer epidemiology in low-income countries. Cancer 2008; 112 (03) 461-472
    CrossrefPubMedGoogle Scholar
  • 6 Dvori M, Elitzur S, Barg A. et al. Delayed diagnosis and treatment of children with cancer during the COVID-19 pandemic. Int J Clin Oncol 2021; 26 (08) 1569-1574
    CrossrefPubMedGoogle Scholar
  • 7 Cox JA, Karlson CW, Dillard BC, Collier III AB. Impact of COVID-19 pandemic on timing of childhood cancer diagnoses. J Pediatr Hematol Oncol 2021; 43 (08) e1244-e1246
    CrossrefPubMedGoogle Scholar
  • 8 Meel R, Radhakrishnan V, Bakhshi S. Current therapy and recent advances in the management of retinoblastoma. Indian J Med Paediatr Oncol 2012; 33 (02) 80-88
    Article in Thieme ConnectPubMedGoogle Scholar
  • 9 Bansal R, Aishwarya A, Rao R. et al. Impact of COVID-19 nationwide lockdown on retinoblastoma treatment and outcome: a study of 476 eyes of 326 children. Indian J Ophthalmol 2021; 69 (10) 2617-2624
    CrossrefPubMedGoogle Scholar
  • 10 Wang H, Elsheikh M, Gilmour K. et al. Impact of COVID-19 pandemic on eye cancer care in United Kingdom. Br J Cancer 2021; 124 (08) 1357-1360
    CrossrefPubMedGoogle Scholar
  • 11 Parasole R, Stellato P, Conter V. et al. Collateral effects of COVID-19 pandemic in pediatric hematooncology: fatalities caused by diagnostic delay. Pediatr Blood Cancer 2020; 67 (08) e28482
    CrossrefPubMedGoogle Scholar
  • 12 Magrath I, Steliarova-Foucher E, Epelman S. et al. Paediatric cancer in low-income and middle-income countries. Lancet Oncol 2013; 14 (03) e104-e116
    CrossrefPubMedGoogle Scholar
  • 13 Totadri S, Trehan A, Kaur A, Bansal D. Effect of socio-economic status & proximity of patient residence to hospital on survival in childhood acute lymphoblastic leukaemia. Indian J Med Res 2019; 149 (01) 26-33
    CrossrefPubMedGoogle Scholar
  • 14 Fabian DI, Stacey WA, Foster A, Kivelä TT. et al. Travel burden and clinical presentation of retinoblastoma: analysis of 1024 patients from 43 African countries and 518 patients from 40 European countries. Br J Ophthalmol 2021; 105 (10) 1435-1443
    PubMedGoogle Scholar
  • 15 Fabian ID, Stacey AW, Foster A. et al. Travel burden and clinical presentation of retinoblastoma: analysis of 1024 patients from 43 African countries and 518 patients from 40 European countries. Br J Ophthalmol 2021; 105 (10) 1435-1443
    CrossrefPubMedGoogle Scholar
  • 16 Fabian ID, Stacey AW, Bowman R. et al; Global Retinoblastoma Study Group. Retinoblastoma management during the COVID-19 pandemic: a report by the Global Retinoblastoma Study Group including 194 centers from 94 countries. Pediatr Blood Cancer 2021; 68 (01) e28584
    CrossrefPubMedGoogle Scholar
  • 17 Gupta AK, Meena JP, Seth R. Reasons for missed chemotherapy appointments in retinoblastoma patients undergoing chemotherapy: a report from a tertiary care hospital from India. Cancer Rep (Hoboken) 2020; 3 (06) e1279
    PubMedGoogle Scholar
  • 18 Hadjistilianou D, Barchitta M, Defrancesco S. Covid-19 and retinoblastoma: how we manage it. Eur J Ophthalmol 2020; 30 (05) NP6-NP10
    CrossrefPubMedGoogle Scholar
  • 19 Skalet AH, Allen RC, Shields CL, Wilson MW, Mruthyunjaya P, Gombos DS. Considerations for the management and triage of ocular oncology cases during the COVID-19 Pandemic. Ocul Oncol Pathol 2020; 6 (03) 1-4
    CrossrefPubMedGoogle Scholar