New method of ophthalmic artery chemotherapy shows promise for treating retinoblastoma

A new technique of direct ophthalmic artery infusion chemotherapy appears effective for treating children with retinoblastoma, with few systemic side effects and minimal local toxicity, according to a study presented at the Society of Interventional Radiology's 33rd Annual Scientific Meeting.

"Among the first 13 cases treated with this technique, 10 eyes destined to be enucleated were salvaged," the authors said in the study's abstract.

Pierre Gobin, MD, and colleagues at Weill Cornell Medical College and Memorial Sloan Kettering Cancer Center in New York evaluated local and systemic toxicity and tolerability for Alkeran (melphalan, GlaxoSmithKline). The drug was administered to 13 children with advanced retinoblastoma using a novel technique of ophthalmic artery infusion.

Children ranged in age from 6 months to 11 years.

During the artery infusion procedure, all patients were anesthetized and treated with anticoagulants. Surgeons then catheterized the ophthalmic artery via a femoral approach and infused melphalan continuously for 30 minutes.

The researchers reported that the ophthalmic arteries were successfully cannulated in 12 children after an average of three treatments. "In one case, catheterization failed and the eye was enucleated," the authors noted.

Three children developed conjunctival and lid edema, which resolved without requiring treatment. However, no children experienced serious systemic side effects, and there was no evidence of toxicity to the cornea, anterior segment, pupil or motility, according to the study.

One eye that had previously been irradiated developed retinal ischemia; another eye developed a radiation-like retinopathy after brachytherapy, the authors noted.

Overall, vision stabilized or improved for 12 children after receiving the chemotherapy, although two eyes eventually were enucleated. However, no viable tumor was identified in either case, they reported.