Favorable outcome of alternate intra-arterial and systemic chemotherapy for retinoblastoma

Abstract

Intra-arterial chemotherapy (IAC) is one of the current standard treatment of retinoblastoma, however it cannot exclude the risk of occult micrometastases in the central nervous system in advanced stage retinoblastoma. Alternate fashion of IAC and intravenous chemotherapy (IVC) strategy was developed to increase the eye salvage rate and to reduce the metastatic risk. Between January 2012 and December 2014, 13 eyes of 12 patients with newly diagnosed retinoblastoma received alternate IAC and IVC in Yonsei Cancer Center. Eye salvage rate was assessed by the eye preservation time which was defined as the duration from the diagnosis to the time of enucleation. Total 13 eyes were classified according to the International Classification of Retinoblastoma (ICRB) as group B (n = 1), group C (n = 2), group D (n = 5), or group E (n = 5). IAC was performed three to five times for each eye, total 54 times. Five to fifteen courses of IVC were performed. During the median follow-up period of 30.4 months, overall eye salvage rate was 63.9 ± 14.7%. All patients survived. The treatment was tolerable without significant complications. Primary alternate IAC-IVC was tolerable and effective for retinoblastoma.