Efficacy of intra-arterial chemotherapy for advanced retinoblastoma after failure of intravenous chemotherapy_Chinese Journal of Ocular Fundus Diseases

Authors：

JiXunda , LiJiakai , ZhaoJunyang , 张靖 , 华续明 , CarolL.Shields ,  赵培泉

Department of Ophthalmology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China;

Corresponding author：

赵培泉, Email: zhaopeiquan@126.com

Keywords：

Retinoblastoma/drug therapy; Chemotherapy, cancer, regional perfusion; Treatment outcome

DOI：

10.3760/cma.j.issn.1005-1015.2015.06.011

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Objective To evaluate the efficacy of intra-arterial chemotherapy (IAC) for advanced retinoblastoma (RB) after failure of intravenous chemotherapy (IVC). Methods Fifteen eyes of 13 patients with advanced RB were treated with IAC (1-5 cycles) after failure of IVC (2-8 cycles). The patients included 10 boys and 3 girls, with the mean age of (15.67±8.16) months. Six patients had bilateral RB and 7 patients had unilateral RB. There were 14 eyes (93.33%) in stage D, 1 eye (6.67%) in stage E according to the International Classification of intraocular retinoblastoma. The main reasons for failure of IVC were recurrent primary tumor in 3 eyes (20.00%), subretinal seeds recurrence in 9 eyes (60.00%), viable vitreous seeds in 2 eyes (13.33%) and poor response of primary tumor in 1 eye (6.67%). The mean interval between IVC completion and IAC start was 3 months. The mean follow-up was 19 months (ranged from 3 to 52 months). Results After IVC and secondary IAC, the retinoblastoma and seeds were regressed in 12 eyes (80.00%). Three eyes required enucleation for severe vitreous seeds, subretinal seeds recurrence and primary tumor recurrence. There was no evidence of metastasis in any case. Conclusion IAC can achieve high global salvage rate (80.00%) for patients with advanced retinoblastoma after failure of IVC.

Citation： JiXunda, LiJiakai, ZhaoJunyang. Efficacy of intra-arterial chemotherapy for advanced retinoblastoma after failure of intravenous chemotherapy. Chinese Journal of Ocular Fundus Diseases, 2015, 31(6): 556-559. doi: 10.3760/cma.j.issn.1005-1015.2015.06.011 Copy

1.	Shields CL, Mashayekhi A, Au AK, et al. The International Classification of Retinoblastoma predicts chemoreduction success[J]. Ophthalmology, 2006, 113(12): 2276-2280.
2.	Shields CL, Ramasubramanian A, Thangappan A, et al. Chemoreduction for group E retinoblastoma: comparison of chemoreduction alone vs chemoreduction plus low dose external radiotherapy in 76 eyes[J]. Ophthalmology, 2009, 116(3): 544-551.
3.	Abramson DH, Dunkel IJ, Brodie SE, et al. A phaseⅠ/Ⅱstudy of direct intraarterial (ophthalmic artery) chemotherapy with melphalan for intraocular retinoblastoma[J]. Ophthalmology, 2008, 115(8): 1398-1404.
4.	Gobin YP, Dunkel IJ, Marr BP, et al. Intra-arterial chemotherapy for the management of retinoblastoma: four-year experience[J]. Arch Ophthalmol, 2011, 129(6): 732-737.
5.	Shields CL, Lally SE, Leahey AM, et al. Targeted retinoblastoma management: when to use intravenous, intra-arterial, periocular, and intravitreal chemotherapy[J]. Curr Opin Ophthalmol, 2014, 25(5): 374-385.
6.	Lumbroso-Le Rouic L, Aerts I, Lévy-Gabriel C, et al. Conservative treatments of intraocular retinoblastoma[J]. Ophthalmology, 2008, 115(8): 1405-1410.
7.	Cohen VML, Kingston J, Hungerford JL. The success of primary chemotherapy for group D heritable retinoblastoma[J]. Br J Ophthalmol, 2009, 93(7): 887-890.
8.	Shields CL, Manjandavida FP, Lally SE, et al. Intra-arterial chemotherapy for retinoblastoma in 70 eyes: outcomes based on the international classification of retinoblastoma[J]. Ophthalmology, 2014, 121(7): 1453-1460.
9.	Schaiquevich P, Ceciliano A, Millan N, et al. Intra-arterial chemotherapy is more effective than sequential periocular and intravenous chemotherapy as salvage treatment for relapsed retinoblastoma[J]. Pediatr Blood Cancer, 2013, 60(5): 766-770.
10.	Peterson EC, Elhammady MS, Quintero-Wolfe S, et al. Selective ophthalmic artery infusion of chemotherapy for advanced intraocular retinoblastoma: initial experience with 17 tumors[J]. J Neurosurg, 2011, 114(6): 1603-1608.
11.	Shields CL, Kaliki S, AI-Dahmash S, et al. Management of advanced retinoblastoma with intravenous chemotherapy then intra-arterial chemotherapy as alternative to enucleation[J]. Retina, 2013, 33(10): 2103-2109.
12.	Shields CL, Bianciotto CG, Jabbour P, et al. Intra-arterial chemotherapy for retinoblastoma:report No. 1, control of retinal tumors, subretinal seeds, and vitreous seeds[J]. Arch Ophthalmol, 2011, 129(11): 1399-1406.
13.	Abramson DH, Marr BP, Dunkel IJ, et al. Intra-arterial chemotherapy for retinoblastoma in eyes with vitreous and/or subretinal seeding: 2-year results[J]. Br J Ophthalmol, 2012, 96(4):499-502.
14.	Munier FL, Gaillard MC, Balmer A, et al. Intravitreal chemotherapy for vitreous disease in retinoblastoma revisited: from prohibition to conditional indications[J]. Br J Ophthalmol, 2012, 96(8): 1078-1083.

1. Shields CL, Mashayekhi A, Au AK, et al. The International Classification of Retinoblastoma predicts chemoreduction success[J]. Ophthalmology, 2006, 113(12): 2276-2280.
2. Shields CL, Ramasubramanian A, Thangappan A, et al. Chemoreduction for group E retinoblastoma: comparison of chemoreduction alone vs chemoreduction plus low dose external radiotherapy in 76 eyes[J]. Ophthalmology, 2009, 116(3): 544-551.
3. Abramson DH, Dunkel IJ, Brodie SE, et al. A phaseⅠ/Ⅱstudy of direct intraarterial (ophthalmic artery) chemotherapy with melphalan for intraocular retinoblastoma[J]. Ophthalmology, 2008, 115(8): 1398-1404.
4. Gobin YP, Dunkel IJ, Marr BP, et al. Intra-arterial chemotherapy for the management of retinoblastoma: four-year experience[J]. Arch Ophthalmol, 2011, 129(6): 732-737.
5. Shields CL, Lally SE, Leahey AM, et al. Targeted retinoblastoma management: when to use intravenous, intra-arterial, periocular, and intravitreal chemotherapy[J]. Curr Opin Ophthalmol, 2014, 25(5): 374-385.
6. Lumbroso-Le Rouic L, Aerts I, Lévy-Gabriel C, et al. Conservative treatments of intraocular retinoblastoma[J]. Ophthalmology, 2008, 115(8): 1405-1410.
7. Cohen VML, Kingston J, Hungerford JL. The success of primary chemotherapy for group D heritable retinoblastoma[J]. Br J Ophthalmol, 2009, 93(7): 887-890.
8. Shields CL, Manjandavida FP, Lally SE, et al. Intra-arterial chemotherapy for retinoblastoma in 70 eyes: outcomes based on the international classification of retinoblastoma[J]. Ophthalmology, 2014, 121(7): 1453-1460.
9. Schaiquevich P, Ceciliano A, Millan N, et al. Intra-arterial chemotherapy is more effective than sequential periocular and intravenous chemotherapy as salvage treatment for relapsed retinoblastoma[J]. Pediatr Blood Cancer, 2013, 60(5): 766-770.
10. Peterson EC, Elhammady MS, Quintero-Wolfe S, et al. Selective ophthalmic artery infusion of chemotherapy for advanced intraocular retinoblastoma: initial experience with 17 tumors[J]. J Neurosurg, 2011, 114(6): 1603-1608.
11. Shields CL, Kaliki S, AI-Dahmash S, et al. Management of advanced retinoblastoma with intravenous chemotherapy then intra-arterial chemotherapy as alternative to enucleation[J]. Retina, 2013, 33(10): 2103-2109.
12. Shields CL, Bianciotto CG, Jabbour P, et al. Intra-arterial chemotherapy for retinoblastoma:report No. 1, control of retinal tumors, subretinal seeds, and vitreous seeds[J]. Arch Ophthalmol, 2011, 129(11): 1399-1406.
13. Abramson DH, Marr BP, Dunkel IJ, et al. Intra-arterial chemotherapy for retinoblastoma in eyes with vitreous and/or subretinal seeding: 2-year results[J]. Br J Ophthalmol, 2012, 96(4):499-502.
14. Munier FL, Gaillard MC, Balmer A, et al. Intravitreal chemotherapy for vitreous disease in retinoblastoma revisited: from prohibition to conditional indications[J]. Br J Ophthalmol, 2012, 96(8): 1078-1083.

Chinese Journal of Ocular Fundus Diseases

Efficacy of intra-arterial chemotherapy for advanced retinoblastoma after failure of intravenous chemotherapy

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