Purpose To evaluate the safety and efficacy of intra-arterial chemotherapy (IAC) for the treatment of children with retinoblastoma.
Methods and materials Retrospective chart review of all pediatric patients with retinoblastoma treated with intra-arterial chemotherapy was performed. Common femoral artery was accessed with the placement of 4Fr sheath in all procedures using ultrasound guidance. Marathon microcatheter was used with .008 or .010 inch wire. Initial angiography of the internal carotid artery was performed to evaluate the territories supplied by the ophthalmic artery and to exclude variant anatomy.
Results Sixty-six ophthalmic arteries in 16 patients (M:F=7:9; mean age= 21 (±9.2 ) months) were catheterized for IAC. The median time for each procedure was under 30 minutes. Three patients had unilateral and 13 had bilateral retinoblastoma. forty-four infusions were performed through the right and 22 through the left side ophthalmic artery. The median number of IAC cycles per patient was 4.1. The Technical success rate was 98% (65 out of 66 procedures) excluding one patient due to the complex anatomy. Hypersensitivity reaction to Melphalan was seen in 2 patients (one requiring adrenaline) during the catheterization procedure. One child eventually ended in enucleation after 4 cycles of IAC.
Conclusions Intra-arterial chemotherapy is an acceptable treatment option for retinoblastoma with a considerable high success rate and low rate of complications; however, attention must be paid to the technical nuances of and indications for its use in order to avoid potential complications.
Disclosures T. Shokuhfar: None. R. Abdalla: None. S. Ansari: None. M. Hurley: None. B. Rahmani: None. A. Shaibani: None.
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