title: Intra-arterial chemotherapy for retinoblastoma: First Indian report.
abstract: OBJECTIVE
  To describe treatment outcomes and complications of selective intra-arterial chemotherapy (IAC) for retinoblastoma (RB) in Indian eyes.
  
  
  METHODS
  Single center, retrospective interventional case series of 6 eyes with RB who underwent IAC using Melphalan (3 mg/5 mg/7.5 mg) and topetecan (1 mg) (n = 4) or melphalan (3 mg/5 mg/7.5 mg) alone (n = 2) between December 2013 and June 2014. In all, 17 IAC procedures were performed using selective ophthalmic artery cannulation. Treatment outcomes were evaluated in terms of tumor control, vitreous and subretinal seeds control and globe salvage rates.
  
  
  RESULTS
  IAC was employed as primary (n = 1) or secondary (n = 5) modality of treatment. Each eye received mean 3 IAC sessions (median: 3; range: 1-4 sessions). Eyes were classified according to international classification of RB as Group B (n = 1), C (n = 1), D (n = 2) and E (n = 2). Following IAC, complete regression of the main tumor was seen in 3 cases (50%), partial regression in 2 (33%), while 1 case (15%) showed no response. Of 4 eyes with subretinal seeds, 1 (25%) eye had complete regression while 3 (75%) eyes had partial regression. Of 5 eyes with vitreous seeds, 2 (40%) eyes had complete regression while 3 (60%) eyes had a partial response. Globe salvage was achieved in 5 of 6 eyes (83%). Diffuse choroidal atrophy and vitreous hemorrhage were observed in 1 (17%) eye, each. No hematologic toxicity or cerebro-vascular events were observed. Mean follow-up period was 5.5 months (median: 6 months, range: 1-6 months).
  
  
  CONCLUSIONS
  IAC is an effective therapy for globe preservation in eyes with RB. Larger studies with longer follow-up are required to validate these results.
authors.affiliation: Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralya, Chennai, Tamil Nadu, India.
authors.forename: Pukhraj
authors.initials: P
authors.lastname: Rishi
authors.forename: Tarun
authors.initials: T
authors.lastname: Sharma
authors.forename: Vikram
authors.initials: V
authors.lastname: Koundanya
authors.forename: Nishat
authors.initials: N
authors.lastname: Bansal
authors.forename: M
authors.initials: M
authors.lastname: Saravanan
authors.forename: R
authors.initials: R
authors.lastname: Ravikumar
authors.forename: Satheesh
authors.initials: S
authors.lastname: Ramamurthy
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage; D016190:Carboplatin / Q000008:administration & dosage*; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D007223:Infant; D007269:Injections, Intra-Arterial; D008297:Male; D008558:Melphalan / Q000008:administration & dosage*; D019572:Retinal Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D012175:Retinoblastoma / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D012189:Retrospective Studies; D013997:Time Factors; D059004:Topoisomerase I Inhibitors / Q000008:administration & dosage; D019772:Topotecan / Q000008:administration & dosage*
chemical_list: D000970:Antineoplastic Agents; D059004:Topoisomerase I Inhibitors; D019772:Topotecan; D016190:Carboplatin; D008558:Melphalan