Intra-arterial chemotherapy for retinoblastoma: Two-year results from tertiary eye-care center in India

Rishi, Pukhraj; Sharma, Tarun; Sharma, Manisha; Maitray, Aditya; Dhami, Abhinav; Aggarwal, Vishvesh; Saravanan, Muthupandian; Ravikumar, R; Ramamurthy, S.

doi:10.4103/ijo.ijo_843_16

Cited by 22 publications

(15 citation statements)

References 14 publications

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“…Various studies have published the outcome of IAC in terms of eye salvage, recurrence, metastasis, and death. However, the choice of drugs, dosage, and techniques vary widely[122324254243444546474849505152535455565758596061] [Table 3]. Lack of prospective randomized clinical trials is a challenge in evaluating the efficacy.…”

Section: Treatment Outcomesmentioning

confidence: 99%

“…Shields et al reported a case of optic neuropathy, and three cases of optic atrophy are reported. [255157] The procedure carries the risk of permanent vision-threatening complications. Associated ischemic and occlusive chorioretinopathy, central retinal artery occlusion, vitreous hemorrhage, and retinal detachment remain a major concern when vision salvage is one of the major goals of procedure.…”

Section: Treatment Complicationsmentioning

confidence: 99%

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Intra-arterial chemotherapy in retinoblastoma – A paradigm change

Manjandavida

Stathopoulos

Zhang

et al. 2019

Indian J Ophthalmol

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Intra-arterial chemotherapy (IAC), also known as superselective ophthalmic artery chemotherapy or chemosurgery, is currently widely accepted as one of the primary treatment modalities for intraocular retinoblastoma worldwide. Following the introduction of the technique in 1998, IAC has evolved over the past decades to be safer and more effective. Accumulated evidence shows that IAC is more effective in providing eye salvage in group D and E retinoblastoma as compared to conventional systemic intravenous chemotherapy (IVC). In contrast to IVC, IAC has the added benefits of reduced overall treatment duration and minimal systemic toxicity. This review provides a comprehensive update on the history, technique, indications, contraindications, and outcome of IAC. We have also identified the strengths, weaknesses, opportunities and threats (SWOT analysis) of the technique in this review.

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Section: Treatment Outcomesmentioning

confidence: 99%

Section: Treatment Complicationsmentioning

confidence: 99%

Intra-arterial chemotherapy in retinoblastoma – A paradigm change

Manjandavida

Stathopoulos

Zhang

et al. 2019

Indian J Ophthalmol

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“…Thermotherapy and cryotherapy were used as adjunctive treatments in both groups if needed. As reported previously, a limitation of IAC is that it could not always control vitreous seeding, 28 as also seen in this study. 4 The main reason for enucleation in this study was unresponsiveness of the main tumor to treatment and 76% of those unresponsive cases were patients with vitreous seeds.…”

Section: Discussionmentioning

confidence: 51%

Five-Year Experience in Treatment of Retinoblastoma with Intra-Arterial Chemotherapy

Dehghani

Ghassemi

Mahmoudzadeh

et al. 2021

Journal of Current Ophthalmology

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Purpose: To report our 5-year experience in treating retinoblastoma (RB) with intra-arterial chemotherapy (IAC) as a primary or secondary therapy, without adjuvant intravitreal chemotherapy. Methods: A retrospective study was conducted on 70 eyes with intraocular RB that were treated with primary or secondary IAC from December 2010-2015. Demographic characteristics, clinical features, tumor control, and treatment complications were compared and reported. Results: Thirty-seven eyes had received IAC as a secondary therapy after failed/incomplete response to systemic chemotherapy, and 33 eyes had received IAC as a primary treatment. The mean age of patients was 25 ± 8.9 months, and the patients were followed for a mean of 24.5 ± 16.26 months. Overall, enucleation rates were significantly higher in advanced tumors (Group D and E) in both groups (both P < 0.05). The main reason for enucleation in this study group was being unresponsive to treatment (27.4%), with 76% of latter patients having vitreous seeds at the time of enucleation. Enucleation rates did not differ significantly between patients receiving primary (18/33, 54%) or secondary IAC (18/37, 48%) ( P = 0.06). In addition, recurrence and complication rates did not differ significantly between eyes receiving IAC as their primary or secondary treatment ( P > 0.05). Conclusion: In primary and secondary treatment of RB with IAC, the main findings that are globe salvage, recurrence, and complication rates were comparable when no adjuvant intravitreal chemotherapy was used.

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“…[ 24 ] In yet another study on 10 eyes with active retinoblastoma who received a mean of 3.8 intra-arterial injection of topotecan and melphalan, the authors found complete regression of the main tumor in 90% and partial regression in 10% of the patients. [ 25 ]…”

Section: Discussionmentioning

confidence: 99%

Periocular topotecan for vitreous seeds in retinoblastoma

Sthapit

Rao

Honavar

2018

Indian J Ophthalmol

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Purpose:Refractory or recurrent vitreous seeds account for a large proportion of failure of eye salvage in retinoblastoma. The purpose of this study is to evaluate the efficacy of periocular topotecan (POT) in the management of vitreous seeds in retinoblastoma.Methods:Retrospective, interventional study of patients with retinoblastoma with vitreous seeds who received POT concurrent with intravenous chemotherapy (IVC).Results:Thirty-eight eyes of 35 patients received POT. Five eyes (13%) belonged to International Classification of Retinoblastoma group C, 23 eyes (61%) belonged to group D, and 10 eyes (26%) belonged to group E. Primary treatment included IVC with a combination of carboplatin, etoposide, and vincristine for a mean of 6 cycles (median 6; range 6–9). Concurrent to IVC from the fourth cycle onward, all patients received POT. Focal vitreous seeds were present in 20 eyes (53%) which received a mean of 3 injections (median 3; range 1–7). Diffuse vitreous seeds were present in 18 eyes (47%) which received a mean of 4 injections (median 5; range 1–7). At a mean follow-up of 8.5 months (median 5 months; range 1–15 months), regression of focal and diffuse vitreous seeds was achieved in 16 eyes (80%) and 8 eyes (44%), respectively. In all, 24 eyes (63%) had complete remission of vitreous seeds with POT given concurrently with IVC. Eye salvage was possible in 19 eyes (95%) with focal vitreous seeds and 12 eyes (68%) with diffuse VS. Enucleation was necessary for persistent vitreous seeds and viable tumor in five eyes (13%), viable tumor alone in one eye (0.02%), and recurrent vitreous seeds in one eye (0.02%). None of the patients developed systemic metastasis.Conclusion:POT administered concurrent with IVC is safe and effective in the initial management of vitreous seeds.

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Intra-arterial chemotherapy for retinoblastoma: Two-year results from tertiary eye-care center in India

Cited by 22 publications

References 14 publications

Intra-arterial chemotherapy in retinoblastoma – A paradigm change

Intra-arterial chemotherapy in retinoblastoma – A paradigm change

Five-Year Experience in Treatment of Retinoblastoma with Intra-Arterial Chemotherapy

Periocular topotecan for vitreous seeds in retinoblastoma

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