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Prashanth G. Iyer, Emil A Say, Murat Hasanreisoglu, Sara Lally, Pascal Jabbour, Carol L Shields; Intra-arterial chemotherapy rescue for recurrent or persistent subretinal seeds in retinoblastoma: Tumor control and globe salvage in 30 eyes. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1664.
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To describe the efficacy of intra-arterial chemotherapy (IAC) for control of persistent or recurrent subretinal seeds in retinoblastoma.
In this retrospective non-comparative interventional case series, there were thirty eyes in 29 patients with retinoblastoma who have failed previous treatment with systemic chemotherapy, plaque radiation, or focal therapy and persistent or recurrent subretinal seeds. Superselective ophthalmic artery chemotherapy infusion under fluoroscopic guidance with melphalan (3, 5, or 7.5 mg) and additional topotecan (1 mg) and/or carboplatin (30 mg) was administered as necessary. The main outcome measures were tumor control and globe salvage.
The mean patient age was 19 months. Secondary IAC was given to patients with recurrent or persistent subretinal seeds who failed previous treatment regimens (n=30 eyes). Each eye received a mean of 3 IAC per eye (median, 2; range, 1-7). After IAC with a mean follow-up of 14 months, 27 of the 30 eyes (90%) had subretinal seed regression after completion of IAC cycles. Long-term control with global salvage was maintained in 19 eyes (63%), with enucleation being required for recurrent subretinal seeds in 3 eyes (27%) and for recurrent subretinal and vitreous seeds in 3 eyes (27%).
IAC is effective as a secondary agent in the management of subretinal seeds in retinoblastoma achieving complete regression of subretinal seeds in 90% of eyes.
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