AIMS: To report outcomes with selective intra-arterial chemotherapy (SIAC) using simultaneous carboplatin, topotecan, and melphalan for advanced intraocular retinoblastoma. METHODS: A retrospective chart review was conducted of patients who received three-drug (melphalan, topotecan, and carboplatin) SIAC during 2006-2011. RESULTS: Twenty-six eyes of 25 patients received the three-drug chemotherapy for treatment of advanced retinoblastoma. Reese-Ellsworth group was 5b in 21 eyes, 5a in 2, 4a in 2, and 3a in 1. Seventeen patients (68%) had recurrence after prior intravenous chemotherapy with or without radiotherapy. In the three-drug therapy, dose ranges were 2.5-7.5 mg for melphalan, 0.3-0.6 mg for topotecan, and 25-50 mg for carboplatin, and median infusions per eye was 2 (range 1-4). At a mean follow-up of 14 months (range 1-43 months), all patients are alive and no patient developed metastatic disease. Twenty-three of 26 eyes (88%) survived. Eleven of the 26 eyes (35%) developed recurrent disease and were treated with enucleation (n=3) or with focal therapy (n=8) with or without plaque brachytherapy (n=3). The Kaplan-Meier estimate of ocular survival at 24 months was 75% (95% CI). Electroretinogram showed improvement greater than 25 µV in 4 eyes (15%), loss greater than 25 µV in 12 eyes (46%), and no change greater than 25 µV in 10 eyes (39%). CONCLUSIONS: Three-drug SIAC has been used successfully to rescue eyes after treatment failure of intravenous chemotherapy and/or single- or double-agent SIAC. Twenty-three of 26 eyes avoided both enucleation and external beam radiotherapy and retained electroretinogram function.
AIMS: To report outcomes with selective intra-arterial chemotherapy (SIAC) using simultaneous carboplatin, topotecan, and melphalan for advanced intraocular retinoblastoma. METHODS: A retrospective chart review was conducted of patients who received three-drug (melphalan, topotecan, and carboplatin) SIAC during 2006-2011. RESULTS: Twenty-six eyes of 25 patients received the three-drug chemotherapy for treatment of advanced retinoblastoma. Reese-Ellsworth group was 5b in 21 eyes, 5a in 2, 4a in 2, and 3a in 1. Seventeen patients (68%) had recurrence after prior intravenous chemotherapy with or without radiotherapy. In the three-drug therapy, dose ranges were 2.5-7.5 mg for melphalan, 0.3-0.6 mg for topotecan, and 25-50 mg for carboplatin, and median infusions per eye was 2 (range 1-4). At a mean follow-up of 14 months (range 1-43 months), all patients are alive and no patient developed metastatic disease. Twenty-three of 26 eyes (88%) survived. Eleven of the 26 eyes (35%) developed recurrent disease and were treated with enucleation (n=3) or with focal therapy (n=8) with or without plaque brachytherapy (n=3). The Kaplan-Meier estimate of ocular survival at 24 months was 75% (95% CI). Electroretinogram showed improvement greater than 25 µV in 4 eyes (15%), loss greater than 25 µV in 12 eyes (46%), and no change greater than 25 µV in 10 eyes (39%). CONCLUSIONS: Three-drug SIAC has been used successfully to rescue eyes after treatment failure of intravenous chemotherapy and/or single- or double-agent SIAC. Twenty-three of 26 eyes avoided both enucleation and external beam radiotherapy and retained electroretinogram function.
Authors: Jasmine H Francis; Y Pierre Gobin; Ira J Dunkel; Brian P Marr; Scott E Brodie; Gowtham Jonna; David H Abramson Journal: PLoS One Date: 2013-08-21 Impact factor: 3.240
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: David H Abramson; Brian P Marr; Jasmine H Francis; Ira J Dunkel; Armida W M Fabius; Scott E Brodie; Ijah Mondesire-Crump; Y Pierre Gobin Journal: PLoS One Date: 2016-06-03 Impact factor: 3.240