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The Efficacy of Alternate Systemic Intravenous Chemotherapy and Intra-arterial Chemotherapy Approach for Eye Globe Salvage in Retinoblastoma

 Jung Woo Han  ;  Christopher Seungkyu Lee  ;  Seung Min Hahn  ;  Won Kee Ahn  ;  Hyo Sun Kim  ;  Hyeseon Yun  ;  Sung Chul Lee  ;  Byung Moon Kim  ;  Dong Joon Kim  ;  Chuhl Joo Lyu 
 CANCER RESEARCH AND TREATMENT, Vol.55(1) : 270-278, 2023-01 
Journal Title
Issue Date
Antineoplastic Combined Chemotherapy Protocols / adverse effects ; Carboplatin ; Humans ; Infant ; Infusions, Intra-Arterial ; Retinal Neoplasms* / diagnosis ; Retinal Neoplasms* / drug therapy ; Retinal Neoplasms* / pathology ; Retinoblastoma* / diagnosis ; Retinoblastoma* / drug therapy ; Retinoblastoma* / pathology ; Retrospective Studies ; Treatment Outcome
Eye globe salvage ; Intra-arterial chemotherapy ; Intravenous chemotherapy ; Retinoblastoma
Purpose: The advances in the treatment of retinoblastoma have enabled salvaging the globe in advanced stages with intra-arterial chemotherapy (IAC). We developed a strategy of alternate application of systemic intravenous chemotherapy (IVC) and IAC (referred to as alternate systemic IVC and IAC; ASIAC) to reduce central nervous metastases during IAC and examined its efficacy and safety in eye globe salvage in this study.

Materials and methods: Between January 2010 and February 2021, 43 eyes of 40 patients received ASIAC treatment for retinoblastoma at the Yonsei Cancer Center, Yonsei University Health System. Their medical records were reviewed retrospectively to evaluate the eye salvage rate (ESR), defined from diagnosis to enucleation. High-risk retinoblastoma was defined as group D or E by the International Classification of Retinoblastoma.

Results: The study enrolled 38 and five cases of high-risk and low-risk retinoblastoma, respectively. In total, 178 IAC and 410 IVC courses were administered, with a median of 4 (interquartile range [IQR], 3.0 to 5.0) IAC and 9 (IQR, 6.0 to 11) IVC courses per eye, respectively. The 5-year ESR was 60.4%±8.7% for the whole cohort, 100% for low-risk retinoblastoma, and 53.6%±9.8% for high-risk retinoblastoma. Among those diagnosed since 2015, the 5-year ESR for high-risk retinoblastoma was 63.5%±14.0%. Fifteen eyes underwent enucleation; no viable tumor was found in three enucleated eyes. There were no deaths in this cohort.

Conclusion: Primary IAC-IVC (i.e., ASIAC) for patients with retinoblastoma was tolerable and effective in salvaging the eye and maintaining survival.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Joon(김동준) ORCID logo https://orcid.org/0000-0002-7035-087X
Kim, Byung Moon(김병문) ORCID logo https://orcid.org/0000-0001-8593-6841
Kim, Hyo Sun(김효선)
Ahn, Won Kee(안원기) ORCID logo https://orcid.org/0000-0003-3668-7396
Lyu, Chuhl Joo(유철주) ORCID logo https://orcid.org/0000-0001-7124-7818
Lee, Sung Chul(이성철) ORCID logo https://orcid.org/0000-0001-9438-2385
Lee, Christopher Seungkyu(이승규) ORCID logo https://orcid.org/0000-0001-5054-9470
Hahn, Seung Min(한승민) ORCID logo https://orcid.org/0000-0001-9832-6380
Han, Jung Woo(한정우) ORCID logo https://orcid.org/0000-0001-8936-1205
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