Superselective intra-arterial chemotherapy treatment for retinoblastoma: clinical experience from a tertiary referral centre

Oto, Bilge Batu; Sarıcı, Ahmet; Kızılkılıç, Osman

doi:10.1016/j.jcjo.2020.04.009

Cited by 6 publications

(6 citation statements)

References 29 publications

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“…The overall success rate in terms of eye salvage has been reported to be in the range of 52%–97% for intraocular RB. [ 1 - 6 ] Shields et al . [ 5 ] have reported 5-year globe salvage rate of 100% in group B and C eyes, 86% in Group D eyes, and 55% in Group E eyes.…”

Section: Discussionmentioning

confidence: 99%

“…Systemic intravenous chemotherapy (IVC) along with focal therapy in the form of laser and cryotherapy have shown very favorable results in salvaging the eyes of nearly 100% of groups A, B, and C tumors. [ 1 - 3 ] However, IVC in cases of advanced Group D and Group E RB with diffuse vitreous seeds (VS) and subretinal seeds (SRS) has shown limited results in terms of eye salvage. [ 4 ] Over the past decade, targeted treatment in the form of intravitreal chemotherapy (IVitC) and intra-arterial chemotherapy (IAC) has completely changed the treatment paradigm for advanced cases of RB and also dramatically improved eye salvage rates in advanced cases.…”

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confidence: 99%

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Intra-arterial chemotherapy in refractory and advanced intraocular retinoblastoma

Kumari

Jain

Saboo

et al. 2023

Indian Journal of Ophthalmology

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Purpose: To evaluate the efficacy of secondary and salvage intra-arterial chemotherapy (IAC) as a globe salvage treatment modality in advanced and refractory intraocular retinoblastoma. Methods: A retrospective chart review of advanced intraocular retinoblastoma (groups D and E International Classification of Retinoblastoma [ICRB] classification) patients refractory to intravenous chemotherapy (IVC) and undergoing IAC as the secondary and salvage treatment modality between December 2018 and June 2021 was carried out. All patients underwent the IAC procedure by super-selective ophthalmic artery catheterization and with triple-drug chemotherapeutic agents of melphalan, topotecan, and carboplatin. Data were collected about tumor regression, eye salvage, metastasis, and survival outcome at follow-up. Results: Out of 13 patients, 12 patients received secondary IAC after being primarily treated with IVC and focal therapies and one patient received rescue IAC after recurrence following primary IAC. Mean number of IAC cycles administered was 2. Overall, globe salvage rate was 53.84%, with a mean follow-up of 17.53 months (range 6–37 months), three patients had enucleation for residual tumor or tumor recurrence. One patient developed metastasis post enucleation and two patients who were lost to follow-up after enucleation advice for residual tumor developed orbital tumor extension and eventually died of metastasis. Conclusion: Secondary triple-drug IAC following failure of IVC, along with other adjunct treatment modalities might a be a cost-effective option for eye salvage in advanced intraocular retinoblastoma patients who refuse enucleation, with a globe salvage rate of 53.84%. It can also be an effective approach to improve treatment compliance and can help in addressing the barrier of treatment refusal when enucleation is advised.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Intra-arterial chemotherapy in refractory and advanced intraocular retinoblastoma

Kumari

Jain

Saboo

et al. 2023

Indian Journal of Ophthalmology

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“…Regarding the available treatment options, this misdiagnosis resulted in enucleation of the eye in that period [ 5 ]. Although the current recommended treatment for RBs that have no vitreous seeding or extraretinal extension is globe-salvaging therapies such as selective intraarterial chemotherapy [ 6 ], the importance of accurate and timely differential diagnosis of RB cannot be adequately emphasized. In our case, intralesional calcification and the absence of a characteristic mulberry-like appearance led to suspicion of RB.…”

Section: Discussionmentioning

confidence: 99%

Multimodal imaging of a sporadic retinal astrocytic hamartoma simulating retinoblastoma in a newborn

Oto

Çebi

Kılıçarslan

et al. 2022

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Introduction: To report a sporadic astrocytic hamartoma simulating retinoblastoma in a newborn. Methods: Clinical data was reviewed retrospectively. Results: A 3-month-old baby with a history of perinatal asphyxia was referred to our ocular oncology clinic with suspected retinoblastoma in the left eye. Dilated fundoscopy revealed a solitary tumor covering the optic disc at the left eye. The whitish-yellow lesion was well-defined, opaque, and minimally calcified. High internal reflectivity and posterior shadowing due to the intralesional calcification, and intratumoral cystic spaces were observed in B-scan ultrasound imaging. Optical coherence tomography imaging showed an intraretinal tumor with cystic spaces and posterior shadowing. The tumor was diagnosed as an astrocytic hamartoma. The systemic evaluation was negative for phacomatoses. The lesion has been observed with multimodal imaging for six years without significant changes. Conclusions: Retinal astrocytic hamartomas are benign tumors that arise within the retinal nerve fiber layer. Differential diagnosis constitutes high importance since they may be misdiagnosed as retinoblastoma, and therefore may be overtreated. Whereas retinoblastoma requires immediate treatment, retinal astrocytic hamartomas are commonly followed-up. Multimodal imaging with B-scan ultrasonography and optical coherence tomography are useful in distinguishing those two entities.

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“…After applying the inclusion and exclusion criteria, nine articles were selected for systematic review and meta-analysis (Table 1). These studies were conducted in China, [17][18][19][20] Egypt, Switzerland, 22 Turkey, 23,24 and the United States, which demonstrates a diverse racial composition of the participants. In this meta-analysis, 596 participants (635 eyes) were studied.…”

Section: Study Characteristicsmentioning

confidence: 99%

Metastatic Death Following Ophthalmic Artery Chemotherapy for Retinoblastoma: A Systematic Review and Meta-analysis

Leelakanok,

Atchaneeyasakul,

Songsaeng

et al. 2024

Siriraj Med J

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Objective: The use of ophthalmic artery chemotherapy (OAC) as a front-line and salvage therapy for retinoblastoma has grown. However, the risk of metastatic death in these patients remains unclear. Materials and Methods: This study of metastatic deaths in OAC may benefit physicians managing retinoblastoma patients. A literature search of Medline, Scopus, Science Direct, and CINAHL was conducted from conception until November 2023. The primary outcome was metastatic death in patients treated with OAC. Results: From the 219 evaluated articles, nine met the inclusion criteria. A total of 596 (635 eyes) patients were treated with OAC; and 20 cases resulted in death due to metastasis of the retinoblastoma. The metastatic mortality rate was 2.5% (95% confidence interval: 0.8%-4.2%) which was statistically significant (p < 0.05). The central nervous system was the most common site of metastasis, followed by multiple sites of metastasis. Conclusion: OAC treatment is associated with the risk of metastatic death, but it is lower than the overall mortality rate of retinoblastoma. Further studies to identify the risk of metastasis are needed.

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Superselective intra-arterial chemotherapy treatment for retinoblastoma: clinical experience from a tertiary referral centre

Cited by 6 publications

References 29 publications

Intra-arterial chemotherapy in refractory and advanced intraocular retinoblastoma

Intra-arterial chemotherapy in refractory and advanced intraocular retinoblastoma

Multimodal imaging of a sporadic retinal astrocytic hamartoma simulating retinoblastoma in a newborn

Metastatic Death Following Ophthalmic Artery Chemotherapy for Retinoblastoma: A Systematic Review and Meta-analysis

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