Methods
A total of 2,200 patients with RB were admitted at the Department of Pediatrics in Beijing Tongren Hospital, Beijing, China, between January 2009 and January 2019. This hospital is one of the largest and best tertiary eye centers in China. Among the patients with RB, five patients with hepatic metastases were eligible for this study, and their clinical data were analyzed retrospectively. The study protocol was approved by the Medical Ethics Committee of the Beijing Tongren Hospital, and written informed consent was obtained from the patients or guardians (in the case of minors) for the publication of this report and associated images. Serum biochemistry, neuron-specific enolase (NSE), alpha fetoprotein (AFP), bone marrow cytology, cerebrospinal fluid cytology, superficial lymph node ultrasound, abdominal computed tomography (CT), and contrast-enhanced magnetic resonance imaging (MRI) of the orbits were performed on all patients. Positron emission tomography (PET)-CT was recommended for all five patients; however, two patients declined for financial reasons.
Multi-drug combination chemotherapy including vincristine, etoposide, carboplatin/cisplatin, cyclophosphaminde/isfosfamide, and topotecan was administered.8 Intrathecal injection of methotrexate, cytosine arabinoside, and dexamethasone was administered when the CNS was involved.10
Abdominal CT and contrast-enhanced MRI of the orbit were performed after every two or three chemotherapy cycles. Radiotherapy after chemotherapy and autologous peripheral blood stem cell transplantation (APBSCT) were scheduled. Adverse reactions to radiotherapy and chemotherapy were evaluated according to the Common Terminology Criteria for Adverse Events guidelines.11