Intra-arterial chemotherapy as a treatment for intraocular retinoblastoma: Alternatives to direct ophthalmic artery catheterization Journal Article
| Authors: | Klufas, M. A.; Gobin, Y. P.; Marr, B.; Brodie, S. E.; Dunkel, I. J.; Abramson, D. H. |
| Article Title: | Intra-arterial chemotherapy as a treatment for intraocular retinoblastoma: Alternatives to direct ophthalmic artery catheterization |
| Abstract: | BACKGROUND AND PURPOSE: Intra-arterial chemotherapy is a very effective treatment option for intraocular retinoblastoma. However, direct catheterization of the OA is not always possible. The purpose of this work was to report our initial results with intra-arterial chemotherapy for intraocular retinoblastoma when delivery of the drug was not via direct catheterization of the OA. MATERIALS AND METHODS: Retrospective review of 110 eyes (89 patients) undergoing a total of 351 intra-arterial treatments at our institution between 2006 and 2010 identified 18 eyes (14 patients) that received at least 1 infusion via a vascular route other than direct OA catheterization. Alternatives included catheterization of the orbital branch of the MMA and temporary balloon occlusion of the ICA. RESULTS: Tumor control was observed in 17 of 18 eyes at a mean follow-up of 18.9 months (median, 17.5 months; range, 8-36 months). The mean number of intra-arterial infusions was 3.7 per eye (median, 3; range, 2-9). Treatment routes included the following: MMA only, 3 eyes; MMA + OA, 4 eyes; MMA + balloon, 2 eyes; balloon only, 1 eye; balloon + OA, 7 eyes; balloon + OA + MMA, 1 eye. Intra-arterial chemotherapies included melphalan, topotecan, and carboplatin. Complications were all transient. ERG readings were the following: stable, 10 eyes; improved, 3 eyes; reduced, 5 eyes. One patient died from a second malignancy (pinealoblastoma). CONCLUSIONS: This initial experience shows that when direct OA catheterization is not possible, using alternative routes of intra-arterial chemotherapy saves eyes and preserves vision with acceptable side effects. |
| Keywords: | survival; major clinical study; neutropenia; topotecan; follow up; carboplatin; antineoplastic combined chemotherapy protocols; melphalan; retinoblastoma; retinal neoplasms; febrile neutropenia; blood transfusion; catheterization; infusions, intra-arterial; radiography, interventional; electroretinography; artery catheterization; eyelid edema; ophthalmic artery; cancer control; bronchospasm; hair loss; pineal body tumor; electroretinogram; hyperemia; balloon occlusion; adrenalin hydrogen tartrate; intraocular tumor; carotid artery, internal; nasal hair loss; meningeal arteries |
| Journal Title: | American Journal of Neuroradiology |
| Volume: | 33 |
| Issue: | 8 |
| ISSN: | 0195-6108 |
| Publisher: | American Society of Neuroradiology |
| Date Published: | 2012-09-01 |
| Start Page: | 1608 |
| End Page: | 1614 |
| Language: | English |
| DOI: | 10.3174/ajnr.A3019 |
| PROVIDER: | scopus |
| PUBMED: | 22442047 |
| PMCID: | PMC7966536 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 1 October 2012" - "CODEN: AAJND" - "Source: Scopus" |
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