Chemosurgery offers safer alternative to systemic chemotherapy for retinoblastoma

NEW YORK — Locally administered chemotherapy offers a safer alternative to systemic chemotherapy and is highly effective in reducing tumor activity in pediatric patients with retinoblastoma.

In a series of 28 eyes with advanced retinoblastoma, 27 were salvaged, with only one eye exhibiting continued tumor activity, according to David H. Abramson, MD. In the procedure, 1 cc of drug was injected to the ophthalmic artery, which was accessed via a catheter placed in the femoral artery; patients required a total of three interventions.

"We call this technique chemosurgery," Dr. Abramson said during a presentation at Retina Congress 2009. "We are no longer using it only for advanced cases, and it is now our primary therapy."

The procedure was associated with a low incidence of ocular toxicity, and there were no systemic adverse events after 3 years. The lack of complications, Dr. Abramson said, reduces overall cost burden compared with traditional therapy, where two-thirds of associated costs are spent on complications.

"Although it is more expensive per day to have intra-arterial chemotherapy, the total cost to the patient is exactly half of that and all the money is spent on cancer treatment," Dr. Abramson said.