Jasmine H Francis1,2, David H Abramson1,2, Xunda Ji3, Carol L Shields4, Luiz F Teixeira5,6, Amy C Schefler7, Nathalie Cassoux8, Doris Hadjistilianou9, Jesse L Berry10, Shahar Frenkel11, Francis L Munier12. 1. Ophthalmic Oncology Service, Memorial Sloan Kettering Cancer Center, New York, New York 2. Department of Ophthalmology, Weill-Cornell Medical Center, New York, New York 3. Department of Ophthalmology, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China 4. Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania 5. Pediatric Oncology Institute, Federal University of São Paulo, São Paulo, Brazil 6. Department of Pediatric Oncology, Santa Marcelina Hospital, São Paulo, Brazil 7. Department of Ophthalmology, Children's Memorial Hermann Hospital, University of Texas, Houston 8. Institut Curie PSL (Paris Science Letter), René Descartes Paris V Universities, Paris, France 9. Department of Ophthalmology, University of Siena, Siena, Italy 10. Children's Hospital Los Angeles, Roski Eye Institute, University of Southern California, Los Angeles 11. Department of Ophthalmology, Hadassah Medical Center, Jerusalem, Israel 12. Department of Ophthalmology, Jules-Gonin Eye Hospital, Lausanne, Switzerland
Abstract
Importance: The risk of extraocular extension from injecting chemotherapy into eyes with retinoblastoma is minimally understood; however, understanding this risk is important because of the increasing use of intravitreous chemotherapy. Objective: To evaluate the risk of extraocular extension in eyes with retinoblastoma that have received intravitreous chemotherapy injections. Design, Setting, and Participants: This retrospective cohort study was performed in 655 patients at 10 retinoblastoma centers in North and South American, European, Israeli, and Chinese centers. Physicians at the retinoblastoma centers administered more than 120 intravitreous chemotherapy injections in eyes with retinoblastoma from February 1, 1999, through February 28, 2017. Main Outcomes and Measures: Risk of extraocular extension with secondary observational variables, including injection and precautionary techniques. Results: A total of 3553 intravitreous chemotherapy injections (3201 melphalan hydrochloride, 335 topotecan hydrochloride, and 17 methotrexate sodium) were administered to 704 eyes in 655 patients with retinoblastoma (mean [SD] age of patients at the time of the initial injections, 31.6 [11.6] months; 348 male [53.1%]). There were no extraocular tumor events related to prior intravitreous injections. This finding resulted in a calculated proportion of zero extraocular events per eye. According to the rule of 3, the risk is no greater than 0.08% injections. All 10 centers included in this study used at least 2 presumed precautionary injection methods (lowering of intraocular pressure, cryotherapy, ocular surface irrigation, ultrasonic biomicroscopy surveillance of the injection site, and subconjunctival chemotherapy deposition). Conclusions and Relevance: With use of at least 2 presumed precautionary safety methods, no extraocular extension of tumor events occurred. According to the rule of 3, this finding suggests that the risk is no greater than 0.08% injections.
Importance: The risk of extraocular extension from injecting chemotherapy into eyes with retinoblastoma is minimally understood; however, understanding this risk is important because of the increasing use of intravitreous chemotherapy. Objective: To evaluate the risk of extraocular extension in eyes with retinoblastoma that have received intravitreous chemotherapy injections. Design, Setting, and Participants: This retrospective cohort study was performed in 655 patients at 10 retinoblastoma centers in North and South American, European, Israeli, and Chinese centers. Physicians at the retinoblastoma centers administered more than 120 intravitreous chemotherapy injections in eyes with retinoblastoma from February 1, 1999, through February 28, 2017. Main Outcomes and Measures: Risk of extraocular extension with secondary observational variables, including injection and precautionary techniques. Results: A total of 3553 intravitreous chemotherapy injections (3201 melphalan hydrochloride, 335 topotecan hydrochloride, and 17 methotrexate sodium) were administered to 704 eyes in 655 patients with retinoblastoma (mean [SD] age of patients at the time of the initial injections, 31.6 [11.6] months; 348 male [53.1%]). There were no extraocular tumor events related to prior intravitreous injections. This finding resulted in a calculated proportion of zero extraocular events per eye. According to the rule of 3, the risk is no greater than 0.08% injections. All 10 centers included in this study used at least 2 presumed precautionary injection methods (lowering of intraocular pressure, cryotherapy, ocular surface irrigation, ultrasonic biomicroscopy surveillance of the injection site, and subconjunctival chemotherapy deposition). Conclusions and Relevance: With use of at least 2 presumed precautionary safety methods, no extraocular extension of tumor events occurred. According to the rule of 3, this finding suggests that the risk is no greater than 0.08% injections.
Authors: Jesse L Berry; Liya Xu; Ashley Polski; Rima Jubran; Peter Kuhn; Jonathan W Kim; James Hicks Journal: Ophthalmology Date: 2019-10-31 Impact factor: 12.079
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: 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: Albert Liao; Terry Hsieh; Jasmine H Francis; Jessica A Lavery; Audrey Mauguen; Scott E Brodie; David H Abramson Journal: Retina Date: 2021-01-01 Impact factor: 3.975