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Effectiveness of Intra-Arterial Chemotherapy for the Treatment of Intraocular Retinoblastoma: Relevance of a Multidisciplinary Setting

PURPOSE: We aim to report about effectiveness and safety in the context of our centers’ setting in the management of retinoblastoma with intra-arterial chemotherapy (IAC) in a 5-year retrospective analysis of the Portuguese population. PATIENTS AND METHODS: Retrospective analysis of consecutive case...

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Autores principales: Castela, Guilherme, Providência, Joana, Monteiro, Madalena, Oliveiros, Bárbara, Silva, Sónia, Brito, Manuel, Machado, Egídio, Neto Murta, Joaquim, Castelo-Branco, Miguel, Correa, Zélia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9901457/
https://www.ncbi.nlm.nih.gov/pubmed/36755890
http://dx.doi.org/10.2147/OPTH.S398488
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author Castela, Guilherme
Providência, Joana
Monteiro, Madalena
Oliveiros, Bárbara
Silva, Sónia
Brito, Manuel
Machado, Egídio
Neto Murta, Joaquim
Castelo-Branco, Miguel
Correa, Zélia
author_facet Castela, Guilherme
Providência, Joana
Monteiro, Madalena
Oliveiros, Bárbara
Silva, Sónia
Brito, Manuel
Machado, Egídio
Neto Murta, Joaquim
Castelo-Branco, Miguel
Correa, Zélia
author_sort Castela, Guilherme
collection PubMed
description PURPOSE: We aim to report about effectiveness and safety in the context of our centers’ setting in the management of retinoblastoma with intra-arterial chemotherapy (IAC) in a 5-year retrospective analysis of the Portuguese population. PATIENTS AND METHODS: Retrospective analysis of consecutive cases of retinoblastoma selected to initiate IAC between 2015 and 2020, at the Portuguese National Reference Center. All included patients underwent complete ophthalmological evaluation under anesthesia with fundus photography. Diagnosis and classification of retinoblastoma was made according to the International Classification of Intraocular Retinoblastoma (ICRB). The patients were further divided into two groups: Group I for primary IAC and Group II for secondary IAC. Tumor recurrence or relapses, systemic metastasis and deaths were documented. Main efficacy outcome included ocular salvage and recurrence-free survival rates estimated using the Kaplan–Meier method. RESULTS: Twenty-eight eyes (19 eyes included in Group I and 9 eyes included in Group II) were eligible and a total of 130 IAC procedures were performed, with a median number of sessions of 4 (range 1–8) for each treated eye, during a median follow-up of 21 months (range 4–64). Of the included eyes, 22 (78.6%) were preserved. An overall survival of 100% was achieved. Considering the preserved eyes, the overall median decimal visual acuity achieved at the last visit was 0.15 (range 0.02–0.8). Three patients had permanent adverse events related to IAC (cataract, vitreous hemorrhage and choroidal ischemia). Considering the survival analysis of recurrence, the mean survival without recurrence was 84.2% for Group I and 66.7% for Group II, and the mean survival without enucleation was 78.6% (no events in Group II). CONCLUSION: IAC has been shown to be an effective and safe treatment for children with intraocular retinoblastoma. This study demonstrates that IAC is effective even in moderate sample sizes, when a multidisciplinary approach is available.
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spelling pubmed-99014572023-02-07 Effectiveness of Intra-Arterial Chemotherapy for the Treatment of Intraocular Retinoblastoma: Relevance of a Multidisciplinary Setting Castela, Guilherme Providência, Joana Monteiro, Madalena Oliveiros, Bárbara Silva, Sónia Brito, Manuel Machado, Egídio Neto Murta, Joaquim Castelo-Branco, Miguel Correa, Zélia Clin Ophthalmol Original Research PURPOSE: We aim to report about effectiveness and safety in the context of our centers’ setting in the management of retinoblastoma with intra-arterial chemotherapy (IAC) in a 5-year retrospective analysis of the Portuguese population. PATIENTS AND METHODS: Retrospective analysis of consecutive cases of retinoblastoma selected to initiate IAC between 2015 and 2020, at the Portuguese National Reference Center. All included patients underwent complete ophthalmological evaluation under anesthesia with fundus photography. Diagnosis and classification of retinoblastoma was made according to the International Classification of Intraocular Retinoblastoma (ICRB). The patients were further divided into two groups: Group I for primary IAC and Group II for secondary IAC. Tumor recurrence or relapses, systemic metastasis and deaths were documented. Main efficacy outcome included ocular salvage and recurrence-free survival rates estimated using the Kaplan–Meier method. RESULTS: Twenty-eight eyes (19 eyes included in Group I and 9 eyes included in Group II) were eligible and a total of 130 IAC procedures were performed, with a median number of sessions of 4 (range 1–8) for each treated eye, during a median follow-up of 21 months (range 4–64). Of the included eyes, 22 (78.6%) were preserved. An overall survival of 100% was achieved. Considering the preserved eyes, the overall median decimal visual acuity achieved at the last visit was 0.15 (range 0.02–0.8). Three patients had permanent adverse events related to IAC (cataract, vitreous hemorrhage and choroidal ischemia). Considering the survival analysis of recurrence, the mean survival without recurrence was 84.2% for Group I and 66.7% for Group II, and the mean survival without enucleation was 78.6% (no events in Group II). CONCLUSION: IAC has been shown to be an effective and safe treatment for children with intraocular retinoblastoma. This study demonstrates that IAC is effective even in moderate sample sizes, when a multidisciplinary approach is available. Dove 2023-02-02 /pmc/articles/PMC9901457/ /pubmed/36755890 http://dx.doi.org/10.2147/OPTH.S398488 Text en © 2023 Castela et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Castela, Guilherme
Providência, Joana
Monteiro, Madalena
Oliveiros, Bárbara
Silva, Sónia
Brito, Manuel
Machado, Egídio
Neto Murta, Joaquim
Castelo-Branco, Miguel
Correa, Zélia
Effectiveness of Intra-Arterial Chemotherapy for the Treatment of Intraocular Retinoblastoma: Relevance of a Multidisciplinary Setting
title Effectiveness of Intra-Arterial Chemotherapy for the Treatment of Intraocular Retinoblastoma: Relevance of a Multidisciplinary Setting
title_full Effectiveness of Intra-Arterial Chemotherapy for the Treatment of Intraocular Retinoblastoma: Relevance of a Multidisciplinary Setting
title_fullStr Effectiveness of Intra-Arterial Chemotherapy for the Treatment of Intraocular Retinoblastoma: Relevance of a Multidisciplinary Setting
title_full_unstemmed Effectiveness of Intra-Arterial Chemotherapy for the Treatment of Intraocular Retinoblastoma: Relevance of a Multidisciplinary Setting
title_short Effectiveness of Intra-Arterial Chemotherapy for the Treatment of Intraocular Retinoblastoma: Relevance of a Multidisciplinary Setting
title_sort effectiveness of intra-arterial chemotherapy for the treatment of intraocular retinoblastoma: relevance of a multidisciplinary setting
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9901457/
https://www.ncbi.nlm.nih.gov/pubmed/36755890
http://dx.doi.org/10.2147/OPTH.S398488
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