Success of intra-arterial chemotherapy (chemosurgery) for retinoblastoma: Effect of orbitovascular anatomy Journal Article
| Authors: | Marr, B. P.; Hung, C.; Gobin, Y. P.; Dunkel, I. J.; Brodie, S. E.; Abramson, D. H. |
| Article Title: | Success of intra-arterial chemotherapy (chemosurgery) for retinoblastoma: Effect of orbitovascular anatomy |
| Abstract: | Objectives: To review results of orbital angiography performed during intra-arterial chemotherapy (chemosurgery) for treatment of retinoblastoma to assess the association of angiographic variability in orbitovascular anatomy with tumor response and outcomes. Methods: Medical records and 64 orbital angiograms were reviewed for 56 pediatric patients with retinoblastoma undergoing chemosurgery using a combination of melphalan hydrochloride, topotecan hydrochloride, or carboplatin. The major orbital arteries and capillary blush patterns were graded, and tumor response and recurrence were compared using the log-rank and Fisher exact tests. Results: Statistically significant variables for tumor response were lacrimal artery prominence (P=.001), previous treatment (P=.003), and lacrimal blush (P=.004). The only statistically significant variable for vitreous seed response was ciliary body blush (P=.03). Statistically significant variables influencing time to recurrence and time to enucleation were choroidal blush absence (P=.01) and lacrimal artery presence (P=.03), respectively. Conclusions: The success of intra-arterial chemotherapy is dependent on delivery of drug to the target tumor within the eye via the ophthalmic artery. Because of the small volume of drug used (0.50-1.25 mL per treatment) and the selectivity of catheterization, variables affecting orbital blood flow greatly influence drug delivery and the success of chemosurgery. ©2012 American Medical Association. All rights reserved. |
| Keywords: | adolescent; adult; child; preschool child; school child; treatment response; major clinical study; review; topotecan; carboplatin; melphalan; retinoblastoma; infant; tumor recurrence; enucleation; external beam radiotherapy; surgical anatomy; chemosurgery; angiography; pediatrics; ocular blood vessel; cryotherapy; vitreous body; orbit; ciliary body; capillary blush; ciliary body blush; lacrimal artery; lacrimal blush; orbital artery; orbital capillary; vitreous seed |
| Journal Title: | Archives of Ophthalmology |
| Volume: | 130 |
| Issue: | 2 |
| ISSN: | 0003-9950 |
| Publisher: | American Medical Association |
| Date Published: | 2012-02-01 |
| Start Page: | 180 |
| End Page: | 185 |
| Language: | English |
| DOI: | 10.1001/archophthalmol.2011.386 |
| PROVIDER: | scopus |
| PUBMED: | 22332209 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 2 April 2012" - "CODEN: AROPA" - "Source: Scopus" |
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