Jesse L Berry1,2, Sona Shah1,2, Mercy Bechtold1,2, Emily Zolfaghari2, Rima Jubran3, Jonathan W Kim1,2. 1. USC Roski Eye Institute, Los Angeles, California. 2. The Vision Center at Children's Hospital Los Angeles, Los Angeles, California. 3. The Children's Center for Cancer and Blood Diseases, Children's Hospital Los Angeles, Los Angeles, California.
Abstract
BACKGROUND: To evaluate outcomes of Group D retinoblastoma (Rb) eyes during the intravitreal melphalan era. PROCEDURE: Retrospective chart review of patients diagnosed with Group D Rb from 2011 to 2016 was done. Overall, 76 Group D eyes of 68 patients were included; salvage therapy included systemic chemoreduction with vincristine, etoposide, and carboplatin with local consolidation, followed by intravitreal injection of melphalan for recurrent or persistent seeding. External beam radiation was not used as a treatment modality. Primary outcome measurement was globe salvage. RESULTS: Of 76 Group D eyes, 24 were enucleated primarily and 52 were treated with intent to salvage the globe. Systemic chemoreduction salvaged 25 of 52 eyes (48%). Tumor recurrences were diagnosed in 27 eyes (52%); five with massive retinal recurrences underwent enucleation and 22 were treated with intravitreal melphalan injection. Of the 22 injected eyes, 14 (64%) were salvaged and eight required enucleation primarily for retinal recurrences. Success in eradicating vitreous seeds was 100%. The Kaplan-Meier 3-year survival estimate for treated eyes is 76.5% (95% CI: 61.4-86.3). Median follow-up for the group of 76 Group D eyes was 29.5 months (SD 17.9 months). CONCLUSION: During a 6-year period that included the initiation of intravitreal melphalan at our institution, the salvage rate of treated Group D eyes was 75% (39/52 eyes). Intravitreal melphalan was utilized for ocular salvage in 42% (22/52 eyes). Systemic chemoreduction combined with intravitreal melphalan for seeding demonstrated a high overall salvage rate for Group D eyes in this cohort.
BACKGROUND: To evaluate outcomes of Group D retinoblastoma (Rb) eyes during the intravitreal melphalan era. PROCEDURE: Retrospective chart review of patients diagnosed with Group D Rb from 2011 to 2016 was done. Overall, 76 Group D eyes of 68 patients were included; salvage therapy included systemic chemoreduction with vincristine, etoposide, and carboplatin with local consolidation, followed by intravitreal injection of melphalan for recurrent or persistent seeding. External beam radiation was not used as a treatment modality. Primary outcome measurement was globe salvage. RESULTS: Of 76 Group D eyes, 24 were enucleated primarily and 52 were treated with intent to salvage the globe. Systemic chemoreduction salvaged 25 of 52 eyes (48%). Tumor recurrences were diagnosed in 27 eyes (52%); five with massive retinal recurrences underwent enucleation and 22 were treated with intravitreal melphalan injection. Of the 22 injected eyes, 14 (64%) were salvaged and eight required enucleation primarily for retinal recurrences. Success in eradicating vitreous seeds was 100%. The Kaplan-Meier 3-year survival estimate for treated eyes is 76.5% (95% CI: 61.4-86.3). Median follow-up for the group of 76 Group D eyes was 29.5 months (SD 17.9 months). CONCLUSION: During a 6-year period that included the initiation of intravitreal melphalan at our institution, the salvage rate of treated Group D eyes was 75% (39/52 eyes). Intravitreal melphalan was utilized for ocular salvage in 42% (22/52 eyes). Systemic chemoreduction combined with intravitreal melphalan for seeding demonstrated a high overall salvage rate for Group D eyes in this cohort.
Authors: Jesse L Berry; Liya Xu; Irsan Kooi; A Linn Murphree; Rishvanth K Prabakar; Mark Reid; Kevin Stachelek; Bao Han A Le; Lisa Welter; Bibiana J Reiser; Patricia Chévez-Barrios; Rima Jubran; Thomas C Lee; Jonathan W Kim; Peter Kuhn; David Cobrinik; James Hicks Journal: Mol Cancer Res Date: 2018-07-30 Impact factor: 5.852
Authors: Liya Xu; Ashley Polski; Rishvanth K Prabakar; Mark W Reid; Patricia Chevez-Barrios; Rima Jubran; Jonathan W Kim; Peter Kuhn; David Cobrinik; James Hicks; Jesse L Berry Journal: Mol Cancer Res Date: 2020-05-20 Impact factor: 5.852
Authors: Rima F Jubran; Judith G Villablanca; Mark Krailo; Jin Piao; Li Huang; A Linn Murphree; Joan O'Brien; Dan Gombos; Carol L Shields; Anna Meadows; Murali Chintagumpala Journal: Pediatr Blood Cancer Date: 2020-06-26 Impact factor: 3.167
Authors: Ramsudha Narala; Jonathan W Kim; Paul Lang; Bao Han A Le; Hansford C Hendargo; Dorothy Branco; Jesse L Berry Journal: Ophthalmol Retina Date: 2018-10-05
Authors: Mary E Kim; Liya Xu; Rishvanth K Prabakar; Lishuang Shen; Chen-Ching Peng; Peter Kuhn; Xiaowu Gai; James Hicks; Jesse L Berry Journal: J Vis Exp Date: 2021-09-07 Impact factor: 1.424
Authors: Lauren A Dalvin; Mamta Kumari; Vera Adobea Essuman; Shormin Shohelly Shipa; David Ancona-Lezama; J Antonio Lucio-Alvarez; Pascal Jabbour; Carol L Shields Journal: Ocul Oncol Pathol Date: 2018-08-21
Authors: Carley M Bogan; Janene M Pierce; Stephanie D Doss; Yuankai K Tao; Sheau-Chiann Chen; Kelli L Boyd; Albert Liao; Terry Hsieh; David H Abramson; Jasmine H Francis; Debra L Friedman; Ann Richmond; Anthony B Daniels Journal: Exp Eye Res Date: 2021-01-11 Impact factor: 3.467