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Three-drug intra-arterial chemotherapy for retinoblastoma may preserve globe
Combined use of carboplatin, topotecan and melphalan in selective intra-arterial chemotherapy successfully rescued eyes with intraocular retinoblastoma after failure of intravenous chemotherapy and/or selective intra-arterial chemotherapy with a single or double agent, according to a study.
“[Selective intra-arterial chemotherapy] is a valuable technique for treating advanced intraocular disease to preserve the globe and avoid the common systemic complications associated with systemic chemotherapy,” the study authors said.
The retrospective chart review included 26 eyes of 25 patients who were treated with selective intra-arterial chemotherapy using melphalan, topotecan and carboplatin for advanced retinoblastoma.
Seventeen patients had prior one- or two-drug selective intra-arterial chemotherapy, while the other eight received three-drug selective intra-arterial chemotherapy as primary treatment. The mean number of three-drug sessions was 2.3 per eye (range: 1 to 4).
At mean final follow-up of 14 months, there were no cases of metastatic disease and all patients survived. Twenty-three of 26 eyes (88%) survived to final follow-up. Eleven eyes (35%) developed recurrent disease.
“This initial study demonstrates that three-drug [selective intra-arterial chemotherapy] can be delivered successfully, and that in the majority of cases it is useful in treating advanced disease and eyes in which single- or double-agent [selective intra-arterial chemotherapy] has failed,” the authors said. “Its role in treatment requires further investigation with continued follow-up.”