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.
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.
Authors: Katarzyna Brodowska; Ahmad Al-Moujahed; Anna Marmalidou; Melissa Meyer Zu Horste; Joanna Cichy; Joan W Miller; Evangelos Gragoudas; Demetrios G Vavvas Journal: Exp Eye Res Date: 2014-05-15 Impact factor: 3.467
Authors: David H Abramson; Anthony B Daniels; Brian P Marr; Jasmine H Francis; Scott E Brodie; Ira J Dunkel; Y Pierre Gobin Journal: PLoS One Date: 2016-01-12 Impact factor: 3.240
Authors: Katarzyna Brodowska; Sofia Theodoropoulou; Melissa Meyer Zu Hörste; Eleftherios I Paschalis; Kimio Takeuchi; Gordon Scott; David J Ramsey; Elizabeth Kiernan; Mien Hoang; Joanna Cichy; Joan W Miller; Evangelos S Gragoudas; Demetrios G Vavvas Journal: Int J Oncol Date: 2014-09-11 Impact factor: 5.650