Article Text
Abstract
Background Retinoblastoma (Rb) is the most common primary ocular malignancy of childhood. Left untreated, it is 100% fatal and carries a substantial risk for impaired vision and removal of one or both eyes. Intraarterial chemotherapy (IAC) for Rb has become a pillar in the treatment paradigm for Rb that allows for better eye salvage and vision preservation without compromising survival. We describe the evolution of our technique over 15 years.
Methods A retrospective chart review was conducted for 571 patients (697 eyes) and 2391 successful IAC sessions over 15 years. This cohort was separated into three 5-year periods (P1, P2, P3) to assess trends in IAC catheterization technique, complications, and drug delivery.
Results From a total of 2402 attempted IAC sessions, there were 2391 successful IAC deliveries, consistent with a 99.5% procedural success rate. The rate of successful super-selective catheterizations over the three periods ranged from 80% in P1, 84.9% in P2, to 89.2% in P3. Catheterization related complication rates ranged from 0.7% in P1, 1.1% in P2, to 0.6% in P3. Chemotherapeutics used included combinations of melphalan, topotecan and carboplatin. The rate of patients receiving triple-therapy among all groups ranged from 128 (21%) in P1, 487 (41.9%) in P2, to 413 (66.7%) in P3.
Conclusions The overall rate of successful catheterization and IAC started high and has improved over 15 years, and catheterization related complications are rare. There is a significant trend towards triple chemotherapy over time.
Disclosures G. Kocharian: None. Y. Gobin: None. N. Kharas: None. J. Knopman: None. J. Francis: None. D. Abramson: None.