Intra-Arterial Chemotherapy Is More Effective Than Sequential Periocular And Intravenous Chemotherapy As Salvage Treatment For Relapsed Retinoblastoma

SCHAIQUEVICH P; CECILIANO A; MILLAN N; TAICH P; VILLASANTE F; FANDIÑO A; DOMINGUEZ J; CHANTADA G

PEDIATRIC BLOOD & CANCER

WILEY-LISS, DIV JOHN WILEY & SONS INC

Lugar: New York; Año: 2013 p. 766 - 770

1545-5009

BACKGROUND: There are few options for retaining an eye with retinoblastoma failing systemic chemoreduction and external beam radiotherapy. This study was done to compare the efficacy and toxicity of intra-arterial ophthalmic artery chemotherapy (IAO) to our historical cohort of sequential periocular and systemic chemotherapy in such patients. PATIENTS AND METHODS: Eighteen eyes (15 consecutive patients) were retrospectively evaluated. Eight eyes received IAO for a median of 4 cycles (range 2 to 9) including melphalan alone (n=3) or after topotecan and carboplatin (n=4) or topotecan and carboplatin without melphalan (n=1). Ten eyes received a median of 2 cycles (range 1 to 3) of periocular topotecan (n=9) or carboplatin (n=1) followed by intravenous topotecan and cyclophosphamide in 3 patients if at least stable disease was achieved. Both groups were comparable in terms of disease extension and prior therapy. RESULTS: No extraocular dissemination or second malignancy occurred and all patients are alive. The probability of enucleation-free survival at 12 months was 0.87 for the IAO group, compared to 0.1 for the periocular group (p