Unilateral Retinoblastoma Managed With Intravenous Chemotherapy Versus Intra-Arterial Chemotherapy. Outcomes Based on the International Classification of Retinoblastoma.

Abstract

PURPOSE:

The objective of this study was to compare outcomes after intravenous chemotherapy (IVC) versus intra-arterial chemotherapy (IAC) for unilateral retinoblastoma.

DESIGN:

A retrospective comparative interventional case series.

METHODS:

Patients with unilateral retinoblastoma managed with either IVC using vincristine, etoposide, and carboplatin or IAC using melphalan with or without topotecan with a minimum of 1-year follow-up were compared. The primary outcome measure was globe salvage.

RESULTS:

Of 91 patients with unilateral retinoblastoma, IVC was employed in 42 (46%) cases and IAC in 49 (54%). By comparison (IVC vs IAC), patients in the IAC group had greater mean tumor diameter (14 vs 18 mm, P < 0.001) and thickness (7 vs 10 mm, P = 0.001), greater percentage with active vitreous seeds (29% vs 55%, P = 0.01), and greater total retinal detachment (10% vs 43%, P < 0.001). There were no cases of group A in either treatment arm. Globe salvage was not significantly different in groups B, C, or E, but there was significantly improved globe salvage with IAC for group D (48% vs 91%, P = 0.004). Control was significantly better with IAC for solid tumor (62% vs 92%, P = 0.002), subretinal seeds (31% vs 86%, P = 0.006), and vitreous seeds (25% vs 74%, P = 0.006). There were no patients with pinealoblastoma, second cancer, metastasis, or death in either group.

CONCLUSIONS:

For unilateral retinoblastoma, IAC provided significantly superior globe salvage compared with IVC for group D eyes. In addition, IAC provided significantly superior control for solid tumor, subretinal seeds, and vitreous seeds.

• Authors: Carol L Shields, Rodrigo Jorge, Emil Anthony T Say, George Magrath, Adel Alset, Emi Caywood, Ann M Leahey, Pascal Jabbour, Jerry A Shields
• Journal: Asia-Pacific journal of ophthalmology (Philadelphia, Pa.) (Asia Pac J Ophthalmol (Phila)) 2016 Mar-Apr Vol. 5 Issue 2 Pg. 97-103 ISSN: 2162-0989 [Electronic] United States
• PMID: 26765038 (Publication Type: Journal Article)

Chemical References

• Vincristine
• Etoposide
• Carboplatin

Topics

• Antineoplastic Combined Chemotherapy Protocols (administration & dosage)
• Carboplatin (administration & dosage)
• Child
• Child, Preschool
• Etoposide (administration & dosage)
• Female
• Humans
• Infant
• Infusions, Intra-Arterial
• Injections, Intravenous
• Male
• Retinal Neoplasms (drug therapy)
• Retinoblastoma (drug therapy)
• Retrospective Studies
• Vincristine (administration & dosage)