Unilateral Retinoblastoma Managed With Intravenous Chemotherapy Versus Intra-Arterial Chemotherapy. Outcomes Based on the International Classification of Retinoblastoma

Author(s)

Shields, Carol L. ^[1] ; Jorge, Rodrigo ^{[1, 2]} ; Say, Emil Anthony T. ^[1] ; Magrath, George ^[1] ; Alset, Adel ^[1] ; Caywood, Emi ^[3] ; Leahey, Ann M. ^[4] ; Jabbour, Pascal ^[5] ; Shields, Jerry A. ^[1]

Affiliation

^[1] Thomas Jefferson Univ, Wills Eye Hosp, Ocular Oncol Serv, Philadelphia, PA 19107 - USA

^[2] Univ Sao Paulo, Dept Ophthalmol Otorhinolaryngol & Head & Neck Su, Ribeirao Preto Med Sch, Sao Paulo - Brazil

^[3] Thomas Jefferson Univ, Nemours Alfred I DuPont Hosp Children, Nemours Ctr Canc & Blood Disorders, Philadelphia, PA 19107 - USA

^[4] Univ Penn, Childrens Hosp Philadelphia, Dept Pediat Oncol, Philadelphia, PA 19104 - USA

^[5] Thomas Jefferson Univ, Dept Neurol Surg, Dept Neurovasc & Endovasc Surg, Philadelphia, PA 19107 - USA

• Document type: Journal article
• Source: ASIA-PACIFIC JOURNAL OF OPHTHALMOLOGY; v. 5, n. 2, p. 97-103, MAR-APR 2016.
• Web of Science Citations: 15

Abstract

Purpose: The objective of this study was to compare outcomes after intravenous chemotherapy (IVC) versus intra-arterial chemotherapy (IAC) for unilateral retinoblastoma. Design: A retrospective comparative interventional case series. Methods: Patients with unilateral retinoblastoma managed with either IVC using vincristine, etoposide, and carboplatin or IAC using melphalan with or without topotecan with a minimum of 1-year follow-up were compared. The primary outcome measure was globe salvage. Results: Of 91 patients with unilateral retinoblastoma, IVC was employed in 42 (46%) cases and IAC in 49 (54%). By comparison (IVC vs IAC), patients in the IAC group had greater mean tumor diameter (14 vs 18 mm, P < 0.001) and thickness (7 vs 10 mm, P = 0.001), greater percentage-with active vitreous seeds (29% vs 55%, P = 0.01), and greater total retinal detachment (10% vs 43%, P < 0.001). There were no cases of group A in either treatment arm. Globe salvage was not significantly different in groups B, C, or E, but there was significantly improved globe salvage with IAC for groupD (48% vs 91%, P = 0.004). Control was significantly better with IAC for solid tumor (62% vs 92%, P = 0.002), subretinal seeds (31% vs 86%, P = 0.006), and vitreous seeds (25% vs 74%, P = 0.006). There were no patients with pinealoblastoma, second cancer, metastasis, or death in either group. Conclusions: For unilateral retinoblastoma, IAC provided significantly superior globe salvage compared with IVC for group D eyes. In addition, IAC provided significantly superior control for solid tumor, subretinal seeds, and vitreous seeds. (AU)

• FAPESP's process: 14/03738-3 - Intravenous versus intra-arterial chemotherapy as primary treatment for Retinoblastoma
• Grantee: Rodrigo Jorge
• Support Opportunities: Scholarships abroad - Research