Carol L Shields1, Rodrigo Jorge, Emil Anthony T Say, George Magrath, Adel Alset, Emi Caywood, Ann M Leahey, Pascal Jabbour, Jerry A Shields. 1. From the *Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA; †Ribeirão Preto Medical School, University of São Paulo, Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, São Paulo, Brazil; ‡Nemours Center for Cancer and Blood Disorders, Nemours/Alfred I. DuPont Hospital for Children at Thomas Jefferson University; §Pediatric Oncology Department, The Children's Hospital of Philadelphia, University of Pennsylvania; and ¶Department of Neurovascular and Endovascular Surgery, Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA.
Abstract
PURPOSE: The objective of this study was to compare outcomes after intravenous chemotherapy (IVC) versus intra-arterial chemotherapy (IAC) for unilateral retinoblastoma. DESIGN: A retrospective comparative interventional case series. METHODS: Patients with unilateral retinoblastoma managed with either IVC using vincristine, etoposide, and carboplatin or IAC using melphalan with or without topotecan with a minimum of 1-year follow-up were compared. The primary outcome measure was globe salvage. RESULTS: Of 91 patients with unilateral retinoblastoma, IVC was employed in 42 (46%) cases and IAC in 49 (54%). By comparison (IVC vs IAC), patients in the IAC group had greater mean tumor diameter (14 vs 18 mm, P < 0.001) and thickness (7 vs 10 mm, P = 0.001), greater percentage with active vitreous seeds (29% vs 55%, P = 0.01), and greater total retinal detachment (10% vs 43%, P < 0.001). There were no cases of group A in either treatment arm. Globe salvage was not significantly different in groups B, C, or E, but there was significantly improved globe salvage with IAC for group D (48% vs 91%, P = 0.004). Control was significantly better with IAC for solid tumor (62% vs 92%, P = 0.002), subretinal seeds (31% vs 86%, P = 0.006), and vitreous seeds (25% vs 74%, P = 0.006). There were no patients with pinealoblastoma, second cancer, metastasis, or death in either group. CONCLUSIONS: For unilateral retinoblastoma, IAC provided significantly superior globe salvage compared with IVC for group D eyes. In addition, IAC provided significantly superior control for solid tumor, subretinal seeds, and vitreous seeds.
PURPOSE: The objective of this study was to compare outcomes after intravenous chemotherapy (IVC) versus intra-arterial chemotherapy (IAC) for unilateral retinoblastoma. DESIGN: A retrospective comparative interventional case series. METHODS:Patients with unilateral retinoblastoma managed with either IVC using vincristine, etoposide, and carboplatin or IAC using melphalan with or without topotecan with a minimum of 1-year follow-up were compared. The primary outcome measure was globe salvage. RESULTS: Of 91 patients with unilateral retinoblastoma, IVC was employed in 42 (46%) cases and IAC in 49 (54%). By comparison (IVC vs IAC), patients in the IAC group had greater mean tumor diameter (14 vs 18 mm, P < 0.001) and thickness (7 vs 10 mm, P = 0.001), greater percentage with active vitreous seeds (29% vs 55%, P = 0.01), and greater total retinal detachment (10% vs 43%, P < 0.001). There were no cases of group A in either treatment arm. Globe salvage was not significantly different in groups B, C, or E, but there was significantly improved globe salvage with IAC for group D (48% vs 91%, P = 0.004). Control was significantly better with IAC for solid tumor (62% vs 92%, P = 0.002), subretinal seeds (31% vs 86%, P = 0.006), and vitreous seeds (25% vs 74%, P = 0.006). There were no patients with pinealoblastoma, second cancer, metastasis, or death in either group. CONCLUSIONS: For unilateral retinoblastoma, IAC provided significantly superior globe salvage compared with IVC for group D eyes. In addition, IAC provided significantly superior control for solid tumor, subretinal seeds, and vitreous seeds.
Authors: A Sweid; B Hammoud; J H Weinberg; P Texakalidis; V Xu; K Shivashankar; M P Baldassari; S Das; S Ramesh; S Tjoumakaris; C L Shields; D Ancona-Lezama; L-A S Lim; L A Dalvin; P Jabbour Journal: AJNR Am J Neuroradiol Date: 2020-06-25 Impact factor: 3.825
Authors: Anthony B Daniels; Shriji N Patel; Ronald W Milam; Sahar Kohanim; Debra L Friedman; Tatsuki Koyama Journal: Cancers (Basel) Date: 2021-05-06 Impact factor: 6.639
Authors: Anthony B Daniels; Michael T Froehler; Janene M Pierce; Amy H Nunnally; M Wade Calcutt; Thomas M Bridges; David C LaNeve; Phillip E Williams; Kelli L Boyd; Michelle L Reyzer; Craig W Lindsley; Debra L Friedman; Ann Richmond Journal: Invest Ophthalmol Vis Sci Date: 2018-01-01 Impact factor: 4.799