March 2012
Volume 53, Issue 14
Free
ARVO Annual Meeting Abstract  |   March 2012
Intra-arterial Chemotherapy for the Management of Retinoblastoma in Eyes with Extensive (>50%) Retinal Detachment
Author Affiliations & Notes
  • Sotiria Palioura
    Ophthalmic Oncology Service, Memorial Sloan-Kettering Cancer Center, New York, New York
    Currently, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts
  • Y. Pierre Gobin
    Division of Interventional Neuroradiology, Departments of Radiology, Neurosurgery and Neurology, Weill Cornell Medical College, New York Presbyterian Hospital, New York, New York
  • Scott E. Brodie
    Ophthalmic Oncology Service, Memorial Sloan-Kettering Cancer Center, New York, New York
    Department of Ophthalmology, Mount Sinai School of Medicine, New York, New York
  • Ira J. Dunkel
    Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, New York
  • Brian P. Marr
    Ophthalmic Oncology Service, Memorial Sloan-Kettering Cancer Center, New York, New York
  • David H. Abramson
    Ophthalmic Oncology Service, Memorial Sloan-Kettering Cancer Center, New York, New York
  • Footnotes
    Commercial Relationships  Sotiria Palioura, None; Y. Pierre Gobin, None; Scott E. Brodie, None; Ira J. Dunkel, None; Brian P. Marr, None; David H. Abramson, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 6867. doi:
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      Sotiria Palioura, Y. Pierre Gobin, Scott E. Brodie, Ira J. Dunkel, Brian P. Marr, David H. Abramson; Intra-arterial Chemotherapy for the Management of Retinoblastoma in Eyes with Extensive (>50%) Retinal Detachment. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6867.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : Superselective delivery of chemotherapy through the ophthalmic artery was introduced by our group 5 years ago for the treatment of eyes with advanced intraocular retinoblastoma otherwise scheduled for enucleation. We now aim to evaluate the efficacy and toxicity of intra-arterial chemotherapy for advanced intraocular retinoblastoma associated with > 50% retinal detachment.

Methods: : Retrospective review of 37 eyes of 34 retinoblastoma patients who had extensive (>50%) retinal detachments and were treated (September 2006-December 2010) with intra-arterial chemotherapy either as primary treatment or as "salvage" treatment after failed systemic chemoreduction and/or external beam radiation (mean follow up, 21 months). Data on patient survival, ocular survival, systemic and ocular complications of intra-arterial chemotherapy treatments, retinal reattachment rates and time course, and serial electroretinograms (ERG) were collected.

Results: : A total of 134 chemotherapy injections (median, 3 per eye) were performed. All children survived. Five eyes (5/37; 14%) were enucleated for progression of disease. No eye was enucleated for complications from treatment. The Kaplan-Meier enucleation-free survival rate at 2 years was 87.9% (95% confidence interval, 76.5%-99.3%). The retina reattached in 28 eyes (28/37; 76%) and the 30-Hz flicker ERGs improved by greater than 25 μV in 7 eyes (7/37; 19%), remained stable (change < 25 μV) in 26 eyes (26/37; 70%), and decreased by greater than 25 μV in 4 eyes (4/37; 11%). The Kaplan-Meier retinal reattachment rate was 58% after 3 intra-arterial chemotherapy infusions (95% confidence interval, 41.9%-74.1%).

Conclusions: : Intra-arterial chemotherapy is effective in preventing enucleation, promoting retinal reattachment and preserving or improving retinal function in the majority of eyes with advanced intraocular retinoblastoma and >50% retinal detachment that would otherwise be considered for enucleation.

Keywords: retinoblastoma • retina • oncology 
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