Faculty Collaboration Database

Intra-arterial chemotherapy for retinoblastoma: report No. 1, control of retinal tumors, subretinal seeds, and vitreous seeds. Arch Ophthalmol 2011 Nov;129(11):1399-406

Date

06/15/2011

Pubmed ID

21670328

DOI

10.1001/archophthalmol.2011.150

Scopus ID

2-s2.0-81355154145 (requires institutional sign-in at Scopus site)   192 Citations

Abstract

OBJECTIVE: To describe tumor control following intra-arterial chemotherapy (IAC) for retinoblastoma.

METHODS: A retrospective interventional series in which 17 patients were treated with ophthalmic artery injection of melphalan, 5 mg, was undertaken to determine retinoblastoma control.

RESULTS: Of 190 children with retinoblastoma, 17 (9%) were treated with IAC. Catheterization was successful in 37 of 38 attempts. The treatment was primary in 13 cases (1 failed catheterization) and secondary in 4. The median retinoblastoma base was 20 mm and the median retinoblastoma thickness was 9.0 mm. Iris neovascularization was present in 5 cases. Following IAC, complete response of the main tumor was found in 14 cases (88%) and partial response was found in 2 (12%). Eyes with complete response and followed up for a minimum of 1 year (n = 10) showed no solid tumor recurrence. Of 11 eyes with subretinal seeds, 9 (82%) had complete response, 1 (9%) had partial response, and 1 (9%) had recurrence. Of 9 eyes with vitreous seeds, 6 (67%) had complete response, 2 (22%) had partial response, and 1 (11%) had recurrence. Globe salvage was achieved in 8 of 12 eyes (67%) treated with primary IAC, including 2 of 2 group C eyes, 4 of 4 group D eyes, and 2 of 6 group E eyes according to the International Classification of Retinoblastoma. Globe salvage was achieved in 2 of 4 eyes (50%) treated secondarily after failure of other methods.

CONCLUSIONS: Of 12 eyes managed with IAC as primary treatment, globe salvage was achieved in 67%. Eyes classified as group C or D showed 100% globe salvage, whereas group E had 33% salvage. Of 4 eyes managed with IAC as secondary treatment, globe salvage was achieved in 50%.

Author List

Shields CL, Bianciotto CG, Jabbour P, Ramasubramanian A, Lally SE, Griffin GC, Rosenwasser R, Shields JA

Author

Aparna Ramasubramanian MD Associate Professor in the Ophthalmology and Visual Sciences department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Antineoplastic Agents, Alkylating
Cerebral Angiography
Chemotherapy, Cancer, Regional Perfusion
Child
Child, Preschool
Electroretinography
Eye Neoplasms
Female
Fluorescein Angiography
Fluoroscopy
Humans
Infant
Injections, Intra-Arterial
Male
Melphalan
Neoplasm Seeding
Ophthalmic Artery
Retinal Neoplasms
Retinoblastoma
Retrospective Studies
Treatment Outcome
Vitreous Body