Irradiation toxic effects during intra-arterial chemotherapy for retinoblastoma: should we be concerned?
OBJECTIVE
To evaluate irradiation toxic effects from fluoroscopy during intra-arterial chemotherapy for retinoblastoma.


METHODS
Prospective trial.


METHODS
Eight patients treated with intra-arterial chemotherapy.


METHODS
Irradiation toxic effects in vital organs.


RESULTS
The mean patient age was 29 months (range, 10-74 months) and 63% were male. The mean irradiation dose to the skin of the affected eye was 0.19173 Gy, to the contralateral eye was 0.03533 Gy, to the chest wall was 0.00296 Gy, and to the abdominal wall was 0.00104 Gy. The estimated irradiation dose to the lens in the treatment eye was 0.16 Gy, which, in accumulated doses, could be cataractogenic. The estimated irradiation dose from a single fluoroscopy session to other organs, including the brain (0.05560 Gy), thyroid (0.00192 Gy), bone marrow (0.00059 Gy), and gonads (0.00015 Gy), was far lower than the minimal toxic level.


CONCLUSIONS
Careful use of fluoroscopy during intra-arterial chemotherapy with limited irradiation exposure is advised. Accumulated irradiation toxic effects following multiple sessions of intra-arterial chemotherapy could be cataractogenic and possibly carcinogenic, especially in irradiation-sensitive patients with retinoblastoma.
Internal Medicine Department, Saint Vincent Hospital, Worcester, Massachusetts, USA.
Rajakrishnan
R
Vijayakrishnan
Carol L
CL
Shields
Aparna
A
Ramasubramanian
Jacqueline
J
Emrich
Robert
R
Rosenwasser
Jerry A
JA
Shields
D034861:Abdominal Wall / Q000528:radiation effects; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D001853:Bone Marrow / Q000528:radiation effects; D001921:Brain / Q000528:radiation effects; D002386:Cataract / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005471:Fluoroscopy / Q000009:adverse effects*; D006801:Humans; D007223:Infant; D007261:Infusions, Intra-Arterial; D007908:Lens, Crystalline / Q000528:radiation effects*; D008297:Male; D011446:Prospective Studies; D011829:Radiation Dosage; D011832:Radiation Injuries / Q000209:etiology*; D019572:Retinal Neoplasms / Q000188:drug therapy*; D012175:Retinoblastoma / Q000188:drug therapy*; D012307:Risk Factors; D012867:Skin / Q000528:radiation effects; D035441:Thoracic Wall / Q000528:radiation effects; D013961:Thyroid Gland / Q000528:radiation effects
D000970:Antineoplastic Agents