Intravenous chemoreduction or intra-arterial chemotherapy for cavitary retinoblastoma: long-term results.
OBJECTIVE
To assess the long-term results of chemotherapy for cavitary retinoblastoma.


METHODS
Retrospective, nonrandomized, interventional case series of 26 cavitary retinoblastomas in 25 eyes of 24 patients. Retinoblastomas were treated with intravenous chemoreduction and/or intra-arterial chemotherapy. Main outcome measures included tumor control, globe salvage, and metastasis.


RESULTS
Of 24 patients with cavitary retinoblastoma, the mean age at diagnosis was 16 months. The mean number of cavitary tumors per eye was 1 (median, 1; range, 1-2), with a mean tumor basal diameter of 13 (median, 13; range, 7-24) mm and mean tumor thickness of 7 (median, 6; range, 3-17) mm. The mean number of cavities per tumor was 2 (median, 2; range, 1-5), with a mean cavity diameter of 3 (median, 2; range, 1-10) mm. Related features included vitreous seeds in 7 tumors (27%), subretinal seeds in 6 (23%), and subretinal fluid in 13 (50%). Intravenous chemoreduction was used in 23 tumors (88%); intra-arterial chemotherapy, in 2 (8%); and both, in 1 (4%). After treatment, the mean reduction in tumor base was 22% and mean reduction in tumor thickness was 29%. Despite minimal reduction, tumor recurrence was noted in only 1 eye (4%), globe salvage was achieved in 22 (88%), and there were no cases of metastasis or death during 49 (range, 6-189) months of follow-up.


CONCLUSIONS
Despite minimal visible tumor response to chemotherapy, cavitary retinoblastoma displays relatively stable long-term results.
Ocular Oncology Service, Wills Eye Institute, Thomas Jefferson University, Philadelphia, PPA 19107, USA.
Duangnate
D
Rojanaporn
Swathi
S
Kaliki
Carlos G
CG
Bianciotto
Juan C
JC
Iturralde
Emil A
EA
Say
Carol L
CL
Shields
D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000627:therapeutic use; D002675:Child, Preschool; D005047:Etoposide / Q000627:therapeutic use; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007261:Infusions, Intra-Arterial; D007262:Infusions, Intravenous; D008297:Male; D008558:Melphalan / Q000627:therapeutic use*; D009880:Ophthalmic Artery; D019572:Retinal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D012175:Retinoblastoma / Q000188:drug therapy* / Q000473:pathology; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014750:Vincristine / Q000627:therapeutic use
D018906:Antineoplastic Agents, Alkylating; D014750:Vincristine; D005047:Etoposide; D016190:Carboplatin; D008558:Melphalan