title: Ophthalmic artery chemosurgery for eyes with advanced retinoblastoma.
abstract: Surgical removal of one or both eyes has been the most common way to treat children with retinoblastoma worldwide for more than 100 years. Ophthalmic artery chemosurgery (OAC) was introduced 10 years ago and it has been used as an alternative to enucleation for eyes with advanced retinoblastoma. The purpose of this report is to analyze our 9-year experience treating advanced retinoblastoma eyes with OAC.
  
  
  
  Single-arm retrospective study from a single center of 226 eyes with eyes of retinoblastoma patients with advanced intraocular disease defined as both Reese-Ellsworth (RE) "Va" or "Vb" and International Classification Retinoblastoma (ICRb) group "D" or "E" (COG Classification). Ocular survival, patient survival, second cancers, and electroretinography (ERG) were assessed.
  
  
  
  Ocular survival at five years for these advanced eyes was 70.2% (95% confidence interval, 57.3%-79.8%). When eyes were divided into groups either by RE classification or ICRb, no significant differences in ocular survival were seen. Ocular survival was significantly better in naïve compared to non-naïve eyes (80.2% vs 58.4%, p = 0.041). The ERG distribution was very similar before and after OAC treatment for the patient population that did not receive intravitreal chemotherapy. Three patients (1.5%) have developed metastatic retinoblastoma (previously reported) and were successfully treated (no deaths).
  
  
  
  Using OAC for advanced eyes (the majority of such eyes have been enucleated in the past) enables 70% 5-year ocular survival. Treated eyes have a similar ERG distribution before and after treatment. No patient has died of metastatic retinoblastoma.
authors.affiliation: a Department of Surgery , Memorial Sloan-Kettering Cancer Center , New York , New York , USA.|b Department of Ophthalmology, Weill Cornell Medical College , New York Presbyterian Hospital , New York , New York , USA.
authors.forename: David H
authors.initials: DH
authors.lastname: Abramson
authors.affiliation: a Department of Surgery , Memorial Sloan-Kettering Cancer Center , New York , New York , USA.|c Department of Ophthalmology , VU University Medical Center , Amsterdam , the Netherlands.
authors.forename: Armida W M
authors.initials: AW
authors.lastname: Fabius
authors.affiliation: a Department of Surgery , Memorial Sloan-Kettering Cancer Center , New York , New York , USA.|b Department of Ophthalmology, Weill Cornell Medical College , New York Presbyterian Hospital , New York , New York , USA.
authors.forename: Jasmine H
authors.initials: JH
authors.lastname: Francis
authors.affiliation: a Department of Surgery , Memorial Sloan-Kettering Cancer Center , New York , New York , USA.|b Department of Ophthalmology, Weill Cornell Medical College , New York Presbyterian Hospital , New York , New York , USA.
authors.forename: Brian P
authors.initials: BP
authors.lastname: Marr
authors.affiliation: d Department of Pediatrics , Memorial Sloan-Kettering Cancer Center , New York , New York , USA.|e Department of Pediatrics, Weill Cornell Medical College , New York Presbyterian Hospital , New York , New York , USA.
authors.forename: Ira J
authors.initials: IJ
authors.lastname: Dunkel
authors.affiliation: a Department of Surgery , Memorial Sloan-Kettering Cancer Center , New York , New York , USA.|f Department of Ophthalmology , Icahn School of Medicine at Mount Sinai , New York , New York , USA.
authors.forename: Scott E
authors.initials: SE
authors.lastname: Brodie
authors.affiliation: g Department of Medicine , Memorial Sloan-Kettering Cancer Center , New York , New York , USA.
authors.forename: Anna
authors.initials: A
authors.lastname: Escuder
authors.affiliation: a Department of Surgery , Memorial Sloan-Kettering Cancer Center , New York , New York , USA.|h Departments of Radiology, Neurosurgery and Neurology, Weill Cornell Medical College , New York Presbyterian Hospital , New York , New York , USA.
authors.forename: Y Pierre
authors.initials: YP
authors.lastname: Gobin
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D016190:Carboplatin / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D004596:Electroretinography; D015353:Eye Enucleation; D005260:Female; D006801:Humans; D007223:Infant; D007261:Infusions, Intra-Arterial; D008297:Male; D008558:Melphalan / Q000008:administration & dosage; D008727:Methotrexate / Q000008:administration & dosage; D009880:Ophthalmic Artery / Q000187:drug effects*; D012160:Retina / Q000502:physiology; D019572:Retinal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D012175:Retinoblastoma / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D012189:Retrospective Studies; D015996:Survival Rate; D019772:Topotecan / Q000008:administration & dosage
chemical_list: D019772:Topotecan; D016190:Carboplatin; D008558:Melphalan; D008727:Methotrexate
keywords: Electroretinography Melphalan; intrarterial chemotherapy; ophthalmic artery chemosurgery; retinoblastoma