title: Intra-arterial chemotherapy for retinoblastoma in eyes with vitreous and/or subretinal seeding: 2-year results.
abstract: OBJECTIVE
  To review the effectiveness of intra-arterial chemotherapy for advanced intra-ocular retinoblastoma with vitreous and/or subretinal seeds in naive (untreated) and previously treated eyes.
  
  
  METHODS
  Retrospective study, approved by the institutional review board, of 76 eyes of 67 patients with retinoblastoma with subretinal and/or vitreous seeding treated with intra-arterial chemotherapy at Memorial Sloan-Kettering Cancer Center between May 2006 and August 2010.
  
  
  RESULTS
  Despite advanced intraocular disease with seeding, the majority (56/76) of eyes were saved; 20/76 eyes were enucleated. Among treatment-naive eyes, the 2-year probability of ocular salvage was 83% (95% CI 27% to 97%) for eyes with subretinal seeding only, 64% (95% CI 24% to 87%) for eyes with vitreous seeding only, and 80% (95% CI 40% to 95%) for eyes with both. Among eyes that received previous treatment and had progressed, the 2-year probability of ocular salvage was 50% (95% CI 15% to 78%) for eyes with only subretinal seeding, 76% (95% CI 48% to 91%) for eyes with vitreous seeding only, and 54% (95% CI 20% to 79%) for eyes with both. Nine of 29 naive eyes (31%) were cured with intra-arterial (super-selective ophthalmic artery infusion of chemotherapy) chemotherapy alone.
  
  
  CONCLUSIONS
  Unlike radiation or systemic chemotherapy, intra-arterial chemotherapy can usually prevent the need for enucleation in naive eyes with advanced intraocular retinoblastoma with seeding-especially if the seeding is subretinal. Treatment appears to be less effective in previously treated eyes when subretinal seeding is present (50% at 2 years), but may be more effective in eyes that failed to respond to previous systemic chemotherapy and have only vitreous seeding.
authors: Ophthalmic Oncology Service, Memorial Sloan-Kettering Cancer Center, New York, New York, USA. abramsod@mskcc.org
authors: David H
authors: DH
authors: Abramson
authors: Brian P
authors: BP
authors: Marr
authors: Ira J
authors: IJ
authors: Dunkel
authors: Scott
authors: S
authors: Brodie
authors: Emily C
authors: EC
authors: Zabor
authors: Sarah J
authors: SJ
authors: Driscoll
authors: Y Pierre
authors: YP
authors: Gobin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D002830:Choroid Neoplasms / Q000188:drug therapy* / Q000556:secondary; D004596:Electroretinography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007269:Injections, Intra-Arterial; D008297:Male; D008875:Middle Aged; D009366:Neoplasm Seeding; D009880:Ophthalmic Artery; D009887:Ophthalmoscopy; D019572:Retinal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D012175:Retinoblastoma / Q000188:drug therapy* / Q000556:secondary; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014822:Vitreous Body; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents