Secondary and tertiary intra-arterial chemotherapy for massive persistent or recurrent subretinal retinoblastoma seeds following previous chemotherapy exposure: long-term tumor control and globe salvage in 30 eyes.

Authors

• Emil Anthony T Say
• Prashanth G Iyer
• Murat Hasanreisoglu
• Sara E Lally
• Pascal Jabbour
• Jerry A Shields
• Carol L Shields

Publication/Presentation Date

8-1-2016

Abstract

PURPOSE: To describe the results of intra-arterial chemotherapy (IAC) for control of persistent or recurrent subretinal seeds (SRS) following previous chemotherapy for retinoblastoma.

METHODS: We reviewed the medical records of patients with massive persistent or recurrent SRS after intravenous and/or intra-arterial chemotherapy and subsequently treated with superselective ophthalmic artery infusion of melphalan (3, 5, or 7.5 mg) and/or additional topotecan (1 mg) and/or carboplatin (20 or 30 mg) as necessary from January 2009 to March 2014. The main outcome measures were SRS control and globe salvage.

RESULTS: A total of 30 eyes of 29 patients were included. Mean patient age was 19 months (median, 14 months; range, 2-58 months). Previous treatments included intravenous chemotherapy (n = 28) and intra-arterial chemotherapy (n = 5). The SRS occupied a median of 6 clock hours. Retinal detachment was present in 5 eyes (17%). Each eye received a mean of 3 IAC sessions (median, 2; range, 1-7) on a monthly basis. After a mean follow-up of 24 months (median, 18; range, 1-71 months), 27 of eyes (90%) demonstrated complete SRS regression. Overall, globe salvage was achieved in 15 eyes (50%). Fifteen eyes were enucleated because of recurrent SRS (4 eyes), recurrent SRS and vitreous seeds (3 eyes), recurrent solid tumor (1 eye), and neovascular glaucoma from total retinal detachment and/or vitreous hemorrhage (7 eyes), none of which had active tumor.

CONCLUSIONS: IAC can be an effective second- or third-line therapy in the management of massive persistent or recurrent SRS from retinoblastoma following previous chemotherapy. All eyes in this study were all facing enucleation; lasting seed control was achieved in 70%.

Volume

20

Issue

4

First Page

337

Last Page

342

ISSN

1528-3933

Published In/Presented At

Say, E. A., Iyer, P. G., Hasanreisoglu, M., Lally, S. E., Jabbour, P., Shields, J. A., & Shields, C. L. (2016). Secondary and tertiary intra-arterial chemotherapy for massive persistent or recurrent subretinal retinoblastoma seeds following previous chemotherapy exposure: long-term tumor control and globe salvage in 30 eyes. Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus, 20(4), 337–342. https://doi.org/10.1016/j.jaapos.2016.05.009

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

27328850

Department(s)

Administration and Leadership

Document Type

Article