Preliminary study on clinical efficacy of intra-arterial chemotherapy and intravenous chemotherapy for unilateral advanced retinoblastoma_Chinese Journal of Ocular Fundus Diseases

Authors：

Liu Dongyue ¹ , Jin Mei ² , Yin Jie ² , Wang Fengxian ¹ , Han Lipo ¹ , Wang Zheng ¹ , Zhang Nan ² , Zhao Junyang ² , Li Li ² ,  Zhang Chengyue ^1,2

1. Department of Ophthalmology, Baoding Children’s Hospital, Baoding 071000, China;
2. Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing 100045, China;

Corresponding author：

Zhang Chengyue, Email: yankeyisheng1979@126.com

Keywords：

Chemotherapy, cancer, regional perfusion; Antineoplastic combined chemotherapy protocols; Retinoblastoma; Child

DOI：

10.3760/cma.j.cn511434-20220131-00057

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Objective To compare the clinical efficacy and complications of intra-arterial chemotherapy (IAC) and intravenous chemotherapy (IVC) for unilateral advanced retinoblastoma (RB). Methods A retrospective clinical study. From January 2020 to January 2021, 40 patients (40 eyes) unilateral group cT2 RB patients diagnosed at Baoding Children’s Hospital and Beijing Children’s Hospital were recruited in this study. There were 22 males (22 eyes) and 18 females (18 eyes). All were monocular. All the patients were assigned to two groups according to different treatment modalities they received: IVC group and IAC group. There were 26 eyes and 14 eyes, respectively. When the tumor invades the optic nerve, choroid, sclera, anterior chamber and iris, enucleation was performed. The globe salvage rate, tumor extraocular metastasis rate, solid tumor control rate, treatment-related complications and pathological high-risk factors after enucleation were observed. The globe salvage rate and solid tumor control rate were compared between the groups by chi square test. Results The globe salvage rate of IAC group and IVC group were 88.5% (23/26) and 50.0% (7/14), respectively. Solid tumor control of IAC group and IVC group were 84.6% (22/26) and 42.9% (6/14), respectively. There were statistically significant differences in globe salvage rate and solid tumor control between the two groups (χ²=7.18, 7.56; P＜0.05). Compared with IVC group, IAC group had less systemic complications, mild ocular and periocular side effects. Among 26 cases in IAC group and 14 cases in IVC group, 3 and 7 cases underwent enucleation respectively. The results of pathological examination showed that there were 2 cases and 3 cases with pathological high-risk factors in the two groups, respectively. During the follow-up period, 2 cases in IAC group had extraocular metastasis, there was no extraocular metastasis in IVC group. Conclusion Compared with IVC, IAC has the advantages of high tumor control rate, high globe salvage rate, less and mild complications, however, there is still tumor recurrence.

Citation： Liu Dongyue, Jin Mei, Yin Jie, Wang Fengxian, Han Lipo, Wang Zheng, Zhang Nan, Zhao Junyang, Li Li, Zhang Chengyue. Preliminary study on clinical efficacy of intra-arterial chemotherapy and intravenous chemotherapy for unilateral advanced retinoblastoma. Chinese Journal of Ocular Fundus Diseases, 2022, 38(3): 187-190. doi: 10.3760/cma.j.cn511434-20220131-00057 Copy

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2.	Shields CL, Shields JA. Intra-arterial chemotherapy for retinoblastoma[J/OL]. JAMA Ophthalmol, 2016, 134(10): 1201[2016-10-01]. https://pubmed.ncbi.nlm.nih.gov/27533705/. DOI: 10.1001/jamaophthalmol.2016.2712.
3.	Abramson DH, Marr BP, Francis JH. Intra-arterial chemotherapy for retinoblastoma[J/OL]. JAMA Ophthalmol, 2016, 134(10): 1202[2016-10-01]. https://pubmed.ncbi.nlm.nih.gov/27533893/. DOI: 10.1001/jamaophthalmol.2016.2714.
4.	Chantada G, Schaiquevich P. Intra-arterial chemotherapy for retinoblastoma[J]. JAMA Ophthalmol, 2016, 134(10): 1202-1203. DOI: 10.1001/jamaophthalmol.2016.2724.
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6.	Shields CL, Shields JA. Basic understanding of current classification and management of relinoblastoma[J]. Curr Opin Ophthalmol, 2006, 17(3): 228-234. DOI: 10.1097/01.icu.0000193079.55240.18.
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8.	中华医学会眼科学分会眼底病学组, 中华医学会儿科学分会眼科学组, 中华医学会眼科学分会眼整形眼眶病学组. 中国视网膜母细胞瘤诊断和治疗指南(2019年)[J]. 中华眼科杂志, 2019, 55(10): 726-738. DOI: 10.3760/cma.j.issn.0412-4081.2019.10.003.Fundus Diseases Group of Ophthalmology Branch of Chinese Medical Association, Ophthalmology Group of Pediatrics Branch of Chinese Medical Association, Ophthalmology Orbital Disease Group of Ophthalmology Branch of Chinese Medical Association. Guidelines for diagnosis and treatment of retinoblastoma in China (2019)[J]. Chin J Ophthalmol, 2019, 55(10): 726-738. DOI: 10.3760/cma.j.issn.0412-4081.2019.10.003.
9.	魏文斌, 周楠. 重视视网膜母细胞瘤的规范化治疗, 提升视网膜母细胞瘤的治疗水平[J]. 中华眼底病杂志, 2020, 36(6): 413-418. DOI: 10.3760/cma.j.cn511434-20200520-00209.Wei WB, Zhou N. Attach importance to standardized treatment of retinoblastoma to improve its treatment outcome[J]. Chin J Ocul Fundus Dis, 2020, 36(6): 413-418. DOI: 10.3760/cma.j.cn511434-20200520-00209.
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11.	Shields CL, Fulco E, Arias JD, et al. Retinoblastoma frontiers with intravenous, intra-arterial, periocular and intravitreal chemotherapy[J]. Eye (Lond), 2013, 27(2): 253-264. DOI: 10.1038/eye.2012.175.
12.	Shields CL, Manjandavida FP, Lally SE, et al. Intra-arterial chemotherapy for retinoblastoma in 70 eyes: outcomes based on the international classification of retinoblastoma[J]. Ophthalmology, 2014, 121(7): 1453-1460. DOI: 10.1016/j.ophtha.2014.01.026.
13.	Shields CL, Mashayekhi A, Au AK, et al. The international classification of retinoblastoma predicts chemoreduction success[J]. Ophthalmology, 2006, 113(12): 2276-2280. DOI: 10.1016/j.ophtha.2006.06.018.
14.	Shields CL, Jorge R, Say EA, et al. Unilateral retinoblastoma managed with intravenous chemotherapy versus intra-arterial chemotherapy. Outcomes based on the international classification of retinoblastoma[J]. Asia Pac J Ophthalmol (Phila), 2016, 5(2): 97-103. DOI: 10.1097/APO.0000000000000172.
15.	Munier FL, Mosimann P, Puccinelli F, et al. First-line intra-arterial versus intravenous chemotherapy in unilateral sporadic group D retinoblastoma: evidence of better visual outcomes, ocular survival and shorter time to success with intra-arterial delivery from retrospective review of 20 years of treatment[J]. Br J Ophthalmol, 2017, 101(8): 1086-1093. DOI: 10.1136/bjophthalmol-2016-309298.

1. Yousef YA, Soliman SE, Astudillo PPP, et al. Intra-arterial chemotherapy for retinoblastoma: a systematic review[J]. JAMA Ophthalmol, 2016, 134(5): 584-591. DOI: 10.1001/jamaophthalmol.2016.0244.
2. Shields CL, Shields JA. Intra-arterial chemotherapy for retinoblastoma[J/OL]. JAMA Ophthalmol, 2016, 134(10): 1201[2016-10-01]. https://pubmed.ncbi.nlm.nih.gov/27533705/. DOI: 10.1001/jamaophthalmol.2016.2712.
3. Abramson DH, Marr BP, Francis JH. Intra-arterial chemotherapy for retinoblastoma[J/OL]. JAMA Ophthalmol, 2016, 134(10): 1202[2016-10-01]. https://pubmed.ncbi.nlm.nih.gov/27533893/. DOI: 10.1001/jamaophthalmol.2016.2714.
4. Chantada G, Schaiquevich P. Intra-arterial chemotherapy for retinoblastoma[J]. JAMA Ophthalmol, 2016, 134(10): 1202-1203. DOI: 10.1001/jamaophthalmol.2016.2724.
5. Soliman SE, Gallie BL, Shaikh F. Intra-arterial chemotherapy for retinoblastoma—reply[J/OL]. JAMA Ophthalmol, 2016, 134(10): 1203[2016-10-01]. https://pubmed.ncbi.nlm.nih.gov/27532440/. DOI: 10.1001/jamaophthalmol.2016.2759.
6. Shields CL, Shields JA. Basic understanding of current classification and management of relinoblastoma[J]. Curr Opin Ophthalmol, 2006, 17(3): 228-234. DOI: 10.1097/01.icu.0000193079.55240.18.
7. Mallipatna A, Gallie BL, Chévez-Barrios P, et al. Retinoblastoma[M]//Amin MB, Edge SB, Greene FL. AJCC cancer staging manual. 8th ed. New York: Springer, 2017: 819-831.
8. 中华医学会眼科学分会眼底病学组, 中华医学会儿科学分会眼科学组, 中华医学会眼科学分会眼整形眼眶病学组. 中国视网膜母细胞瘤诊断和治疗指南(2019年)[J]. 中华眼科杂志, 2019, 55(10): 726-738. DOI: 10.3760/cma.j.issn.0412-4081.2019.10.003.Fundus Diseases Group of Ophthalmology Branch of Chinese Medical Association, Ophthalmology Group of Pediatrics Branch of Chinese Medical Association, Ophthalmology Orbital Disease Group of Ophthalmology Branch of Chinese Medical Association. Guidelines for diagnosis and treatment of retinoblastoma in China (2019)[J]. Chin J Ophthalmol, 2019, 55(10): 726-738. DOI: 10.3760/cma.j.issn.0412-4081.2019.10.003.
9. 魏文斌, 周楠. 重视视网膜母细胞瘤的规范化治疗, 提升视网膜母细胞瘤的治疗水平[J]. 中华眼底病杂志, 2020, 36(6): 413-418. DOI: 10.3760/cma.j.cn511434-20200520-00209.Wei WB, Zhou N. Attach importance to standardized treatment of retinoblastoma to improve its treatment outcome[J]. Chin J Ocul Fundus Dis, 2020, 36(6): 413-418. DOI: 10.3760/cma.j.cn511434-20200520-00209.
10. Dimaras H, Corson TW, Cobrinik D, et al. Retinoblastoma[J/OL]. Nat Rev Dis Primers, 2015, 27 (1): 15021[2015-08-27]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5744255/. DOI: 10.1038/nrdp.2015.21.
11. Shields CL, Fulco E, Arias JD, et al. Retinoblastoma frontiers with intravenous, intra-arterial, periocular and intravitreal chemotherapy[J]. Eye (Lond), 2013, 27(2): 253-264. DOI: 10.1038/eye.2012.175.
12. Shields CL, Manjandavida FP, Lally SE, et al. Intra-arterial chemotherapy for retinoblastoma in 70 eyes: outcomes based on the international classification of retinoblastoma[J]. Ophthalmology, 2014, 121(7): 1453-1460. DOI: 10.1016/j.ophtha.2014.01.026.
13. Shields CL, Mashayekhi A, Au AK, et al. The international classification of retinoblastoma predicts chemoreduction success[J]. Ophthalmology, 2006, 113(12): 2276-2280. DOI: 10.1016/j.ophtha.2006.06.018.
14. Shields CL, Jorge R, Say EA, et al. Unilateral retinoblastoma managed with intravenous chemotherapy versus intra-arterial chemotherapy. Outcomes based on the international classification of retinoblastoma[J]. Asia Pac J Ophthalmol (Phila), 2016, 5(2): 97-103. DOI: 10.1097/APO.0000000000000172.
15. Munier FL, Mosimann P, Puccinelli F, et al. First-line intra-arterial versus intravenous chemotherapy in unilateral sporadic group D retinoblastoma: evidence of better visual outcomes, ocular survival and shorter time to success with intra-arterial delivery from retrospective review of 20 years of treatment[J]. Br J Ophthalmol, 2017, 101(8): 1086-1093. DOI: 10.1136/bjophthalmol-2016-309298.

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Preliminary study on clinical efficacy of intra-arterial chemotherapy and intravenous chemotherapy for unilateral advanced retinoblastoma

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