Combined chemotherapy and intra-arterial chemotherapy of retinoblastoma.
10.3345/kjp.2013.56.6.254
- Author:
Saerom CHOI
1
;
Jung Woo HAN
;
Hyosun KIM
;
Beom Sik KIM
;
Dong Joon KIM
;
Sung Chul LEE
;
Chuhl Joo LYU
Author Information
1. Division of Pediatric Hematology and Oncology, Department of Pediatrics, Yonsei University Health System, Seoul, Korea. cj@yuhs.ac
- Publication Type:Original Article
- Keywords:
Retinoblastoma;
Combination chemotherapy;
Intra-arterial infusion;
Eye enucleation
- MeSH:
Child;
Disease-Free Survival;
Drug Therapy, Combination;
Eye;
Eye Enucleation;
Humans;
Infusions, Intra-Arterial;
Recurrence;
Retinoblastoma;
Retrospective Studies;
Sample Size
- From:Korean Journal of Pediatrics
2013;56(6):254-259
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Retinoblastoma (RB) is the most common primary malignant intraocular tumor in children. Although systemic chemotherapy has been the primary treatment, intra-arterial chemotherapy (IAC) represents a new treatment option. Here, we performed alternate systemic chemotherapy and IAC and retrospectively reviewed the efficacy and safety of this approach. METHODS: Patients diagnosed with intraocular RB between January 2000 and December 2011 at Severance Children's Hospital, Yonsei University, were reviewed. Before February 2010, the primary treatment for RB was chemotherapy (non-IAC/CTX). Since February 2010, the primary treatment for RB has been IAC (IAC/CTX). External beam radiotherapy or high-dose chemotherapy were used as "last resort" treatments just prior to enucleation at the time of progression or recurrence during primary treatment. Enucleation-free survival (EFS) and progression-free survival were assessed. RESULTS: We examined 19 patients (median age, 11.9 months; range, 1.4 to 75.6 months) with a sum of 25 eyes, of which, 60.0% were at advanced Reese Ellsworth (RE) stages. The enucleation rate was 33.3% at early RE stages and 81.8% at advanced RE stages (P=0.028). At 36 months, EFS was significantly higher in the IAC/CTX group than in the non-IAC/CTX group (100% vs. 40.0%, P=0.016). All 5 patients treated with IAC achieved eye preservation, although most patients were at advanced RE stages (IV-V). CONCLUSION: Despite the limitation of a small sample size, our work shows that an alternative combined approach using IAC and CTX may be safe and effective for eye preservation in advanced RB.
