Intra‑arterial chemotherapy for retinoblastoma: First Indian report.
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Date
2015-04
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Abstract
Aim: To describe treatment outcomes and complications of selective intra‑arterial chemotherapy (IAC)
for retinoblastoma (RB) in Indian eyes. Materials and Methods: Single center, retrospective interventional
case series of 6 eyes with RB who underwent IAC using Melphalan (3 mg/5 mg/7.5 mg) and
topetecan (1 mg) (n = 4) or melphalan (3 mg/5 mg/7.5 mg) alone (n = 2) between December 2013 and June
2014. In all, 17 IAC procedures were performed using selective ophthalmic artery cannulation. Treatment
outcomes were evaluated in terms of tumor control, vitreous and subretinal seeds control and globe salvage
rates. Results: IAC was employed as primary (n = 1) or secondary (n = 5) modality of treatment. Each eye
received mean 3 IAC sessions (median: 3; range: 1–4 sessions). Eyes were classified according to international
classification of RB as Group B (n = 1), C (n = 1), D (n = 2) and E (n = 2). Following IAC, complete regression
of the main tumor was seen in 3 cases (50%), partial regression in 2 (33%), while 1 case (15%) showed no
response. Of 4 eyes with subretinal seeds, 1 (25%) eye had complete regression while 3 (75%) eyes had
partial regression. Of 5 eyes with vitreous seeds, 2 (40%) eyes had complete regression while 3 (60%) eyes
had a partial response. Globe salvage was achieved in 5 of 6 eyes (83%). Diffuse choroidal atrophy and
vitreous hemorrhage were observed in 1 (17%) eye, each. No hematologic toxicity or cerebro‑vascular
events were observed. Mean follow‑up period was 5.5 months (median: 6 months, range: 1–6 months).
Conclusion: IAC is an effective therapy for globe preservation in eyes with RB. Larger studies with longer
follow‑up are required to validate these results.
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Keywords
Eye, intra‑arterial chemotherapy, retinoblastoma, tumor
Citation
Rishi Pukhraj, Sharma Tarun , Koundanya Vikram, Bansal Nishat, Saravanan M, Ravikumar R, Ramamurthy Satheesh. Intra‑arterial chemotherapy for retinoblastoma: First Indian report. Indian Journal of Ophthalmology. 2015 Apr; 63(4): 331-334.