Abstract
Background: Intra-arterial chemotherapy (IAC) for retinoblastoma (Rb) has dramatically altered the natural history of the disease. The spectacular outcomes associated with a high safety profile have pushed the envelope to offer treatment for patients < 10 kg of weight. Objective: We aim to share our findings and experience in a large series of IAC infusions performed in infants < 10 kg. Methods: A retrospective chart review was performed for patients diagnosed with retinoblastoma and managed with IAC as either primary or secondary treatment. Results: There were 207 Rb tumors of 207 eyes in 197 consecutive patients. Of these, patient weight was 10 kg in 69 (35.7%) and >10 kg in 133 (67.5%) patients. Of the 69 patients weighing < 10 kg, 5 patients had bilateral Rb. Thus, a total of 74 eyes of 69 patients weighing < 10 kg were compared to 133 eyes of 133 patients weighing > 10 kg. Comparison ( < 10 kg vs. >10 kg) revealed the total number of IAC cycles was 222 vs. 436. Periprocedural complications occurred in 2 (0.9%) vs. 2 (0.45%) infusions ( p =0.49). Aborted procedure occurred in 12 (5.4%) vs. 7 (1.6%) infusions ( p =0.005). Enucleation following IAC was required in 14 (18.9) vs. 44 (33%) eyes ( p =0.029). On multivariate analysis, weight < 10 kg was not an independent predictor of complications, procedure failure, or eye enucleation. Conclusions: Our results speak for the safety and efficacy of IAC in patients < 10 kg.
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