More Cycles of Intravenous Chemotherapy are Associated with Reduced Growth in Children with Retinoblastoma

Abstract: Background Chemotherapy can have a negative impact on the growth of children with different cancers. However, few studies have examined whether intravenous chemotherapy (IVC) affects the growth of children with retinoblastoma (RB). The present study evaluated the height differences (actual height compared to the agestandardized value) and survival of pediatric RB patients treated with IVC. Methods This was an observational cohort study. A total of 87 pediatric RB patients were included. The study population was stratified into two groups based on the number of chemotherapy cycles administered (≤ 4 versus > 4). The height at baseline (before IVC), height after IVC and overall survival were compared between the two groups. Results Before IVC, no height differences were observed between the two groups (P = 0.585). After IVC, all of the patients had a reduced height compared to the agestandardized height (P = 0.035). Patients who underwent more cycles of chemotherapy had a greater height difference compared to those who received fewer cycles (P = 0.008). For those who had reduced height, the difference was positively associated with the number of chemotherapy cycles (r = 0.279, P = 0.043). Among the patients who exhibited a greater height difference, those who underwent more than four cycles of chemotherapy had a decreased overall survival (P = 0.042). Conclusions Pediatric RB patients who underwent more cycles of chemotherapy were more likely to have a reduced height. Further studies are needed to determine the optimal treatment strategy to prevent the reduced growth while maintaining the benefits of chemotherapy.