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Evaluation the initial outcomes in treatment of retinoblastoma by using intra-arterial chemotherapy
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Abstract
SUMMARY
Retinoblastoma is the most common malignant tumor eye tumor in children which can cause blindness and even mortality if diagnosis and treatment are delayed. Intra-arterial chemotherapy (IAC) under the guidance of radiology is a new method for the treatment of intraocular retinoblastomas.
Purpose: To evaluate the initial outcomes and safety of intra-arterial chemotherapy in treatment retinoblastoma.
Materials and Methods: 15 patients diagnosed with intraocular retinoblastoma were clinically and subclinically examined, made imaging diagnosis (ultrasound and MRI), then define retinoblastoma stage by the 2003 international classification, whether or not it has been combine with other methods , and then is indicated for IAC, from October 2017 to June 2019. Each intervention is 3-4 weeks apart. The patients were followed immediately after treatment for the clinical symptoms and after 3-4 weeks after intervention to reassess the tumors and treatment results.
Results: 15 patients (including 6 males and 9 females) corresponded to 15 study eyes with an average 35,5 ±20,8 age of months (11 months to 84 months). According to the International classification, there are 3 patients (20%) of group B retinoblastoma, 6 patients (40%) of group C retinoblastoma, 6 patients (40%) of group D retinoblastoma , no patients in group A and group E. The total number of tumors in 15 eyes is 27, which has been treated with intravenous chemotherapy combined with one or two local treatments (laser and cryotherapy) . The total number of interventions was 29, each patiens was treated from 1 to 3 times. As a result, 4 patients (26,7%) had good treatment results, 8 patients (53,3%) had average results, 3 patients (20%) had bad results, then had to enucleate; No patient were distant metastases or death during the follow-up. As a result, we saved 12/15 eyes at the risk of enucleation, 2/15 patients had complications of the treatment process, 1 patient had erythema of the eyelid and forehead skin area, 1 patient had choroidal - retinal atrophy due to occlusive vasculopathy.
Conclusions: The method of intra- arterial chemotherapy in the treatment of retinoblastoma has promising, safe, and effective initial results in maximally salvaging the eye.