Secondary and tertiary intra-arterial chemotherapy for massive persistent or recurrent subretinal retinoblastoma seeds following previous chemotherapy exposure: long-term tumor control and globe salvage in 30 eyes

Say, Emil Anthony T.; Iyer, Prashanth G.; Hasanreisoğlu, Murat; Lally, Sara E.; Jabbour, Pascal; Shields, Jerry A.; Shields, Carol L.

doi:10.1016/j.jaapos.2016.05.009

Cited by 12 publications

(12 citation statements)

References 27 publications

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“…In view of this, IAC is utilized mainly in treating patients with intraocular disease without local or systemic spread. Previous studies on IAC have shown that it can be used successfully as a primary retinoblastoma treatment in DOI: http://dx.doi.org/10.5772/intechopen.86820 naïve eyes (no previous therapy employed) or as a secondary treatment in eyes with recurrent or residual tumor after trying other treatment modalities such as systemic chemotherapy, external beam radiotherapy and others [29,[31][32][33][34][35][36][37]. Currently, the common indications for IAC in retinoblastoma patients include unilateral retinoblastoma that cannot be halted by local treatments alone (e.g., cryotherapy or laser photocoagulation) and advanced unilateral retinoblastoma (such as group D and E based on the ICRB) [30].…”

Section: Indicationsmentioning

confidence: 99%

Retinoblastoma Management: Advances in Chemotherapy

Kofide¹,

Al-Sharif²

2019

Retinoblastoma - Past, Present and Future

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The treatment of children with retinoblastoma (RB) has evolved from primarily enucleation of the eye(s) to highly selective methods of chemotherapy administration and approach. Indulgent and comprehensive understanding of the multitude of factors including accurate classification and grading of disease, timing and response to therapy, when to consolidate with local methods of therapy, combination regimens to control systemic disease and prevent relapse while minimizing risk of secondary cancers are crucial factors in the management of children with retinoblastoma. Chemotherapy was introduced in the 1950s and has become an integral component in management of RB. Methods of administration range from systemic to locally directed therapy including; intravitreal, periocular and intraarterial chemotherapy. This chapter is intended to discuss the evolution and current chemotherapeutic agents with various routes of administration. The indications, adverse occurrences, short-and long-term complications of both local and systemic treatments will be elucidated.

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Section: Indicationsmentioning

confidence: 99%

Retinoblastoma Management: Advances in Chemotherapy

Kofide¹,

Al-Sharif²

2019

Retinoblastoma - Past, Present and Future

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“…[12] Since then, several investigators have reported their experience with IAC. [131415161718192021222324252627282930] In a study done by Tuncer et al ., 26 Group D eyes of 24 treatment-naïve Rb patients managed primarily with IAC were included. [19] Each eye received a mean of three IAC sessions/eye (range, 2–5 sessions).…”

Section: Globe-saving Treatmentsmentioning

confidence: 99%

“…[26] In another interesting study, the results of IAC for control of persistent or recurrent sub-retinal seeds following previous chemotherapy for Rb were reported. [27] A total of thirty eyes of 29 patients were included in this study. Each eye received a mean of three IAC sessions.…”

Section: Globe-saving Treatmentsmentioning

confidence: 99%

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Recent advances and challenges in the management of retinoblastoma

Chawla

Singh

2017

Indian J Ophthalmol

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The treatment of retinoblastoma (Rb) has improved significantly in recent times. Worldwide, there is an increasing trend to use conservative treatment modalities that aim to preserve the globe as well as vision with minimum morbidity. Recently, the use of targeted delivery of chemotherapy to the eye in the form of selective intra-arterial and intravitreal chemotherapy has shown promising results. Radiotherapy is beneficial in selected cases, either in the form of plaque brachytherapy or as external beam radiotherapy. Orbital disease carries a poor prognosis for survival. However, a multimodal treatment protocol has improved survival in children with extraocular disease. Nevertheless, challenges remain, especially for the developing world. This review aims to highlight recent advances in the management of Rb that have contributed towards improving treatment outcomes and also discuss the challenges ahead, with special reference to the Indian scenario.

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“…evaluated the role of secondary and tertiary IAC in eyes with massive SRS and found SRS regression in 70% cases and globe salvage in 50% cases. [9] Hereby, we present our 2-year results of IAC in eyes with RB among Indian partcipants. To the best of our knowledge, this is the first report of a 2-year follow-up for IAC-treated eyes with RB from India.…”

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confidence: 99%

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

Rishi

Sharma

et al. 2017

Indian J Ophthalmol

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Aim:The aim of this study is to describe treatment outcomes and complications of selective intra-arterial chemotherapy (IAC) for intraocular retinoblastoma (RB).Materials and Methods:A retrospective, interventional series of 10 eyes with RB which underwent IAC using melphalan (5 mg/7.5 mg) and topotecan (1 mg), or melphalan (5 mg/7.5 mg) alone. Treatment outcomes were evaluated in terms of tumor control, vitreous seeds (VS) and subretinal seeds (SRS) control, and globe salvage rates.Results:Ten eyes of 10 patients underwent 38 IAC sessions (mean = 3.8; median = 4; range = 3–5 sessions). Following IAC, complete regression of main tumor was seen in 9 eyes (90%) and partial regression in 1 (10%). All four eyes with SRS showed complete regression (100%). Of 5 eyes with VS, 3 eyes (60%) showed complete regression, 1 eye (20%) showed relapse, while 1 eye (20%) showed no response. Globe salvage was achieved in 8 of 10 eyes (80%). Complications included transient ophthalmic artery narrowing (n = 2), branched retinal vein occlusion (n = 1), forehead skin pigmentation (n = 1), and vitreous hemorrhage (n = 2). There was no case of stroke, hemiplegia, metastasis, or death. Transient hematological changes included relative pancytopenia (n = 4), relative leukopenia (n = 5), and relative thrombocytopenia (n = 4). Mean follow-up was 26 months (median = 28, range = 13–36) from the initiation of first IAC.Conclusions:IAC is an effective therapy for globe preservation in eyes with intraocular RB, in the setting of a developing country like India. Larger studies with longer follow-up are required to validate these results.

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Secondary and tertiary intra-arterial chemotherapy for massive persistent or recurrent subretinal retinoblastoma seeds following previous chemotherapy exposure: long-term tumor control and globe salvage in 30 eyes

Cited by 12 publications

References 27 publications

Retinoblastoma Management: Advances in Chemotherapy

Retinoblastoma Management: Advances in Chemotherapy

Recent advances and challenges in the management of retinoblastoma

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

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