Purpose Background: To describe the efficacy of intra‐arterial chemotherapy combined with intravitreal chemotherapy for the treatment of advanced stage retinoblastoma
Methods The Authors report the medical records of four patients who presented with unilateral retinoblastoma, (Reese‐Ellsworth stage Vb/ group D of ABC Classification in the affected eye). They underwent clinical and ophthalmoscopic evaluation and MRI to exclude local and CNS dissemination. All 4 patients received 2 cycles (six infusions) of intrarterial chemotherapy (4‐5 mg of melphalan/0.3‐0.4 mg of topotecan), and from 7 up to 9 melphalan injections into the vitreous (10‐30μg in 0.05 mL).
Results Successful control of tumor masses and vitreous seeds was achieved in all cases at long‐term (> 6 months) follow‐up. Tumor control was 100% in all cases. Complications included: posterior lens opacities, acute ischemic papillitis, transient hypotonia, vitreous hemorrhage. There were no cases of orbital tumor recurrence or metastasis (follow‐up range, 6 – 12 months).
Conclusion Sequential intra‐arterial chemotherapy and intravitreal melphalan for advanced retinoblastoma allowed to provide retinal and vitreous seed control