Abstract
AimTo report our first three-and-a-half years’ experience with intra-arterial chemotherapy (IAC) in managing retinoblastoma (RB).MethodsSingle institution, retrospective, interventional case series of 14 retinoblastoma patients managed with IAC from December 2014 to June 2018. Demographics were described. Outcomes measures were tumor response, treatment complications and globe salvage.ResultsSubjects’ mean age at the first administration of IAC was 31.4 months. 57.1% of the eyes were Group D and E retinoblastoma, while 79% were bilateral disease. 93% of the eyes were as secondary treatment. Of 32 IAC cannulations performed, 23 (71.8%) were successful and received chemotherapy drug melphalan. Each eye received a mean of 1.8 (range 1–4) IAC injections. 53% of the eyes showed regression post treatment. After a mean follow up period of 19 months, globe salvage rate was 38%. Most of the adverse effects experienced were localized and transient.ConclusionIAC has provided an added recourse in the armamentarium of retinoblastoma treatment in our center. IAC treatment is a viable alternative in the treatment of retinoblastoma to salvage globe, for eyes that would conventionally require enucleation especially in bilateral disease.
Highlights
Retinoblastoma (RB) is the most common intraocular malignancy in children
Subjects’ mean age at the first administration of intra-arterial chemotherapy (IAC) was 31.4 months. 57.1% of the eyes were Group D and E retinoblastoma, while 79% were bilateral disease. 93% of the eyes were as secondary treatment
IAC treatment is a viable alternative in the treatment of retinoblastoma to salvage globe, for eyes that would conventionally require enucleation especially in bilateral disease
Summary
Retinoblastoma (RB) is the most common intraocular malignancy in children. This aggressive cancer is fatal if left untreated, but early diagnosis and treatment advancement have made RB a highly curable disease. The current trends of treatment focused on maximizing ocular salvage while conserving vision and limiting side effects. Intra-arterial chemotherapy (IAC) has gained popularity worldwide as a promising therapy in RB. It provides a high success rate of globe salvage and tumor control, with a good safety profile. Literatures on IAC treatment in retinoblastoma are limited, especially in South East Asia region. Most of the literatures were retrospective, single-arm case series. [4]
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