Carol L Shields1, Swathi Kaliki, Saad Al-Dahmash, Duangnate Rojanaporn, Ann Leahey, Gregory Griffin, Pascal Jabbour, Jerry A Shields. 1. *Ocular Oncology Service, Wills Eye Institute, Thomas Jefferson University, Philadelphia, Pennsylvania; †Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia; ‡Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; §Division of Pediatric Hematology/Oncology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; ¶Division of Pediatric Hematology/Oncology, A.I. duPont Hospital for Children, Thomas Jefferson University, Wilmington, Delaware; and **Division of Neurovascular and Endovascular Surgery, Neurosurgery Department, Thomas Jefferson University, Philadelphia, Pennsylvania.
Abstract
PURPOSE: To determine the efficacy of primary intravenous chemotherapy (IVC) plus secondary intraarterial chemotherapy (IAC) for patients with advanced retinoblastoma. METHODS: Retrospective, nonrandomized interventional case series of 14 patients with retinoblastoma managed with primary systemic IVC (vincristine, etoposide, and carboplatin for 6 cycles) followed by secondary IAC (melphalan for 1-6 cycles). RESULTS: Fourteen patients with advanced retinoblastoma classified by the International Classification of Retinoblastoma as Group D (n = 6, 43%) or Group E (n = 8, 57%) were treated with IVC as primary treatment and subsequent secondary IAC as rescue or consolidation therapy. The IAC was given for recurrent retinoblastoma and/or subretinal/vitreous seeds in 13 eyes (93%) and for persistent viable retinoblastoma in 1 eye (7%). Enucleation was the alternative option. The mean interval between IVC completion and IAC start was 40 weeks (median, 11 weeks; range, 2-170 weeks) and the mean number of IAC cycles was 3 (median, 3; range, 1-6). After primary IVC plus secondary IAC, globe salvage was achieved in 8 patients (57%) at mean 2-year follow-up. There was no evidence of retinoblastoma metastasis or death and no sign of second cancer or life-threatening complication. CONCLUSION: For advanced retinoblastoma (Groups D and E) in which enucleation is the alternative option, primary systemic IVC followed by secondary focal IAC provides globe salvage in 57% of the eyes and with no metastatic event.
PURPOSE: To determine the efficacy of primary intravenous chemotherapy (IVC) plus secondary intraarterial chemotherapy (IAC) for patients with advanced retinoblastoma. METHODS: Retrospective, nonrandomized interventional case series of 14 patients with retinoblastoma managed with primary systemic IVC (vincristine, etoposide, and carboplatin for 6 cycles) followed by secondary IAC (melphalan for 1-6 cycles). RESULTS: Fourteen patients with advanced retinoblastoma classified by the International Classification of Retinoblastoma as Group D (n = 6, 43%) or Group E (n = 8, 57%) were treated with IVC as primary treatment and subsequent secondary IAC as rescue or consolidation therapy. The IAC was given for recurrent retinoblastoma and/or subretinal/vitreous seeds in 13 eyes (93%) and for persistent viable retinoblastoma in 1 eye (7%). Enucleation was the alternative option. The mean interval between IVC completion and IAC start was 40 weeks (median, 11 weeks; range, 2-170 weeks) and the mean number of IAC cycles was 3 (median, 3; range, 1-6). After primary IVC plus secondary IAC, globe salvage was achieved in 8 patients (57%) at mean 2-year follow-up. There was no evidence of retinoblastoma metastasis or death and no sign of second cancer or life-threatening complication. CONCLUSION: For advanced retinoblastoma (Groups D and E) in which enucleation is the alternative option, primary systemic IVC followed by secondary focal IAC provides globe salvage in 57% of the eyes and with no metastatic event.
Authors: Christina Scelfo; Jasmine H Francis; Vikas Khetan; Thomas Jenkins; Brian Marr; David H Abramson; Carol L Shields; Jacob Pe'er; Francis Munier; Jesse Berry; J William Harbour; Andrey Yarovoy; Evandro Lucena; Timothy G Murray; Pooja Bhagia; Evelyn Paysse; Samuray Tuncer; Guillermo L Chantada; Annette C Moll; Tatiana Ushakova; David A Plager; Islamov Ziyovuddin; Carlos A Leal; Miguel A Materin; Xun-Da Ji; Jose W Cursino; Rodrigo Polania; Hayyam Kiratli; Charlotta All-Ericsson; Rejin Kebudi; Santosh G Honavar; Vicktoria Vishnevskia-Dai; Sidnel Epelman; Anthony B Daniels; Jeanie D Ling; Fousseyni Traore; Marco A Ramirez-Ortiz Journal: Int J Ophthalmol Date: 2017-06-18 Impact factor: 1.779
Authors: David H Abramson; Xunda Ji; Jasmine H Francis; Federica Catalanotti; Scott E Brodie; Larissa Habib Journal: Br J Ophthalmol Date: 2018-06-06 Impact factor: 4.638
Authors: Jasmine H Francis; David H Abramson; Y Pierre Gobin; Brian P Marr; Irwin Tendler; Scott E Brodie; Ira J Dunkel Journal: Ophthalmology Date: 2015-01-21 Impact factor: 12.079