Abstract
Purpose:
To evaluate the outcome of 20 eyes, with recurrent or refractory retinoblastoma after intravenous chemotherapy, using selective intra-arterial chemotherapy (SIAC) and/or intravitreal chemotherapy (IViC).
Methods:
Retrospective study, approved by the institutional review board, of 20 eyes of 17 patients. SIAC was used as first option in cases with retinal or subretinal disease with or without vitreous seeding. IViC was used for isolated vitreous disease or for complementary treatment in eyes with partial vitreous seeding response to SIAC. Focal therapy was used as needed to consolidate treatment.
Results:
Twenty eyes of 17 patients were treated. 15 (75%) eyes were treated with SIAC, 2 (10%) eyes with IViC and 3 (15%) eyes with both therapies. SIAC was used in 18 eyes. (melphalan plus topotecan and carboplatin in 15 eyes; melphalan plus topotecan in 1 eye and melphalan in 2 eyes). The median infusions per eye were 2 (range 1-3). Dose ranges were 3-5 mg for melphalan, 0,3-0,4 mg for topotecan and 30-40 mg for carboplatin. Five eyes received IViC (melphalan 30 μg in 0,05 ml - every 7 days). The median injectios were 5 (range 2-7). At a median follow up of 11 months (range 3-30 months) all patients are alive with no metastatic disease. 17 of 20 eyes (85%) were preserved.
Conclusions:
The use of both therapies SIAC and IViC as isolated modality or in combination to treat recurrent or refractory retinoblastoma showed successfully results in globe preservation.
Keywords: 703 retinoblastoma •
744 tumors •
624 oncology