Regression time shorter with ophthalmic artery chemosurgery plus intravitreous chemotherapy

Ophthalmic artery chemosurgery with intravitreous chemotherapy to treat class 3 retinoblastoma vitreous seeds resulted in a shorter time to regression compared with ophthalmic artery chemosurgery alone, according to a retrospective study.

Researchers at Memorial Sloan-Kettering Cancer Center included 40 eyes containing clouds (class 3 vitreous seeds) of 40 retinoblastoma patients; 19 were treated with ophthalmic artery chemosurgery (OAC) and 21 were treated with OAC plus intravitreous and periocular chemotherapy. Time to regression of seeds, ocular survival and disease-free survival were the main outcome measures.

Eyes that underwent OAC plus intravitreous chemotherapy experienced a statistically significant shorter time to regression of seeds of 5.7 months compared with 14.6 months for eyes treated with OAC alone (P < .001). Kaplan-Meier 18-month disease-free survival estimates were significantly worse in eyes treated with OAC alone at 67.1% compared with 94.1% for eyes treated with OAC plus intravitreous chemotherapy (P = .05). The 36-month Kaplan-Meier survival estimates were 83.3% for OAC alone and 100% for OAC plus intravitreous chemotherapy; this difference was not statistically significant.

“The treatment of class 3 (cloud) vitreous seeds by combination OAC plus intravitreous chemotherapy seems to be more efficient (as seen in shorter time to regression) and to lead to fewer recurrences, additional treatments and enucleations compared with treatment with OAC alone,” the researchers wrote. “This combination treatment is accompanied by a lower overall total melphalan dose and does not seem to increase retinal toxicity significantly as measured by electroretinography.” – by Robert Linnehan

Disclosure: The authors report no relevant financial disclosures.

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Source:

Francis JH, et al. Ophthalmology. 2017;doi:10.1016/j.ophtha.2017.04.010.