Abstract
Purpose :
Among various treatment options for retinoblastoma intraarterial chemotherapy may
be followed by laser or cryotherapy, brachytherapy or external beam radiotherapy. We report the efficacy of ruthenium plaque therapy secondary to intraarterial chemotherapy (IAC) of intraocular retinoblastoma.
Methods :
Retrospective case series of 4 consecutive patients. Ruthenium brachytherapy was performed in accordance with the american brachytherapy society consensus guidelines for brachytherapy of uveal melanoma and
retinoblastoma.
Results :
4 patients with advanced retinoblastoma (unilateral in three cases) received primary treatment with IAC and secondary treatment with ruthenium brachytherapy for consolidation or localized recurrence. IAC treatment included Melphalan in 3 and Melphalan/Topotecan in one case. Ruthenium plaque therapy was performed 3-16 months after IAC. One patient was treated with a second plaque 37 months after IAC. The mean prescribed apex dose was 80 Gray. Initial grouping (ICRB, 2006), was D1 and D2 in two cases, respectively. In two cases enucleation was performed 6 and 8 months after brachytherapy, respectively. The reason was recurrence and proliferative vitreoretinopathy in one and retinal detachment along with IAC-induced chorioretinal atrophy in the second case. Final visual acuity in the remaining two cases was 20/20 with full stereopsis at 7.1 and 5.8 years of follow-up.
Conclusions :
Due to various treatment options for retinoblastoma therapy needs to be individually optimized to save the patient’s life and preserve visual function. Ruthenium plaque treatment may effectively control localized residual and recurrent disease in retinoblastoma after primary treatment with IAC and, therefore contribute to long-term visual function.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.