Secondary salvage intravenous chemotherapy for refractory/recurrent retinoblastoma: A study of 41 eyes
Swathi Kaliki, Suneetha Gavara, Gaurav Patil, Vijay Anand Reddy Palkonda- Ophthalmology
- General Medicine
Abstract
Purpose:
To determine the efficacy of secondary salvage intravenous chemotherapy (IVC) for refractory/recurrent retinoblastoma (RB).
Methods:
Retrospective, nonrandomized interventional case series of 41 eyes of 33 patients with RB
Results:
Of the 33 patients, mean age at the time of commencement of salvage IVC was 5 years (median, 5 years; range, 2 to 8 years). At presentation, RB in 41 eyes of 33 patients were classified by the International Classification of Retinoblastoma as Group B (n=7, 17%), Group C (n=3, 7%), Group D (n=16, 39%) and Group E (n=15, 37%). All patients received 6 cycles of IVC as primary treatment. The indication for secondary salvage IVC with focal treatment included recurrent solid tumor (n=36; 88%), subretinal seeds (n=22; 54%), or persistent solid tumor (n=2; 5%). Mean number of cycles of salvage IVC were 8 (median, 6; range, 6 to 18). Over a mean follow-up period of 43 months (median, 43 months; range, 12 to 96 months) after completion of salvage IVC, globe salvage was achieved in 22 (54%) eyes, 1 (3%) patient had histopathology-proven bone metastasis, and 1 (3%) patient died due to presumed metastasis.
Conclusion:
Secondary salvage IVC with appropriate focal treatment allows globe salvage in 54% eyes with refractory/recurrent RB and thus serves as an alternative to intra-arterial chemotherapy or enucleation.