Paediatric retinoblastoma care between 2020 and 2024: a national perspective
DOI:
https://doi.org/10.56294/shp202213Keywords:
retinoblastoma, pediatric oncology, Argentina, treatment, equityproposeAbstract
During the period 2020-2024, Argentina faced a challenging health and socioeconomic scenario that directly impacted the approach to pediatric retinoblastoma. Early diagnosis and access to adequate treatments were affected by the COVID-19 pandemic and by structural inequalities in the health system. This led to diagnoses at advanced stages, which required more invasive therapies such as enucleation, with significant functional and emotional consequences for patients.
The study analyzed the response of the Argentine health system, highlighting the role of the Garrahan National Pediatric Hospital as a reference center. There, chemoreduction was prioritized as initial treatment, complemented in many cases by radiotherapy or surgery. It was observed that local treatments, such as cryotherapy or brachytherapy, offered good results in early stages, although their availability was limited. The aesthetic and functional effect of therapies such as external radiotherapy was also identified, in contrast to more conservative methods.
It was concluded that the quality of treatment depended to a large extent on access to specialized centers, the socioeconomic level of the patients and the existence of interdisciplinary teams. Although there were legislative advances, such as the Oncopediatrics Act, challenges persisted in its implementation and in territorial equity. The study highlighted the need to strengthen local research, decentralize care and guarantee psychosocial support, in order to improve clinical outcomes and the quality of life of patients with retinoblastoma in the country.
References
1. Ellsworth RM. Diagnosis of retinoblastoma. *Trans New Orleans Acad Ophthalmol*. New York: Raven Press; 1984. p. 1–6.
2. Adhi MI, Kashif S, Muhammed K, Siyal N. Clinical pattern of Retinoblastoma in Pakistani population: review of 403 eyes in 295 patients. *J Pak Med Assoc*. 2018;68(3):376–80.
3. Shields CL, Shields JA. Retinoblastoma management: advances in enucleation, intravenous chemoreduction, and intra-arterial chemotherapy. *Curr Opin Ophthalmol*. 2010;21:203–12.
4. Dudgeon J. Retinoblastoma--trends in conservative management. *Br J Ophthalmol*. 1995;79(2):104.
5. Fernández Fastuca DL, Sgroi M, Fandiño AC, Sampor C, Esquivel Y, Chantada G. Evaluación de secuelas visuales y cosméticas del tratamiento conservador con terapia radiante externa en pacientes con retinoblastoma bilateral en el Hospital de Pediatría Garrahan [Internet]. *Med Infant*. [citado 2024 Oct 14];22(2):88–96. Disponible en: https://www.medicinainfantil.org.ar/images/stories/volumen/2015/xxii_2_088.pdf
6. Cidad Betegón MP. Evaluación del tratamiento del retinoblastoma unilateral [Tesis doctoral en Internet]. Madrid: Universidad Autónoma de Madrid; [citado 2024 Oct 14]. Disponible en: https://repositorio.uam.es/bitstream/handle/1046//cidad_betegon_maria_del_pino.pdf?sequence=1&isAllowed=y
7. Zhan C, Finger PT, Gallie B, Tomar AS, Kivelä A. Global retinoblastoma treatment outcomes: association with national income level. [s.l.]: [s.n.]; [s.f.].
8. Shields CL, Ancona-Lezama D, Dalvin LA. Modern treatment of retinoblastoma: a 2020 review. *Indian J Ophthalmol*. 2020;68(11):2356. https://doi.org/10.4103/ijo.ijo_721_20
9. Ademola-Popoola DS, Opocher E, Reddy MA. Contemporary management of retinoblastoma in the context of a low-resource country. *Niger Postgrad Med J*. 2019;26(2):69–79.
10. Rajeshuni N, Whittemore AS, Ludwig CA, et al. Racial, ethnic, and socioeconomic disparities in retinoblastoma enucleation: a population-based study, SEER 18 2000–2014. *Am J Ophthalmol*. 2019;207:215–23.
11. Hurwitz RL, Shields CL, Shields JA, et al. Retinoblastoma. In: Pizzo PA, Poplack DG, editors. *Principles and Practice of Pediatric Oncology*. 7th ed. Philadelphia: Lippincott Williams & Wilkins; 2016. Chapter 27.
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