Efficacy of intra-arterial chemotherapy for advanced retinoblastoma after failure of intravenous chemotherapy

Abstract

Objective To evaluate the efficacy of intra-arterial chemotherapy (IAC) for advanced retinoblastoma (RB) after failure of intravenous chemotherapy (IVC). Methods Fifteen eyes of 13 patients with advanced RB were treated with IAC (1 - 5 cycles) after failure of IVC (2 - 8 cycles). The patients included 10 boys and 3 girls, with the mean age of (15.67±8.16) months. Six patients had bilateral RB and 7 patients had unilateral RB. There were 14 eyes (93.33%) in stage D, 1 eye (6.67%) in stage E according to the International Classification of intraocular retinoblastoma. The main reasons for failure of IVC were recurrent primary tumor in 3 eyes (20.00%), subretinal seeds recurrence in 9 eyes (60.00%), viable vitreous seeds in 2 eyes (13.33%) and poor response of primary tumor in 1 eye (6.67%). The mean interval between IVC completion and IAC start was 3 months. The mean follow-up was 19 months (ranged from 3 to 52 months). Results After IVC and secondary IAC, the retinoblastoma and seeds were regressed in 12 eyes (80.00%). Three eyes required enucleation for severe vitreous seeds, subretinal seeds recurrence and primary tumor recurrence. There was no evidence of metastasis in any case. Conclusion IAC can achieve high global salvage rate (80.00%) for patients with advanced retinoblastoma after failure of IVC. Key words: Retinoblastoma/drug therapy; Chemotherapy, cancer, regional perfusion; Treatment outcome